Chapter 4 Flashcards
Psychology
Theories of the origins of behavior and risk-taking tendencies and methods for altering individual and social behaviors
Sociology
Theories of social development, organizational behavior, and systems thinking; social impacts on individual and group behaviors
Anthropology
Social and cultural influences on individual and population decision-making for health with a global perspective
Political science/public policy
Approaches to government and policy making related to public health; structures for policy analysis and the impact of government on public health decision-making
Economics
Understanding the micro- and macroeconomic impact on public health and healthcare systems
Communications
Theory and practice of mass and personalized communication and the role of media in communicating health information and health risks
Demography
Understanding demographic changes in populations globally due to aging, migration, and differences in birth rates, plus their impact on health and society
Geography
Understanding the impacts of geography on disease and determinants of disease, as well as methods for displaying and tracking the location of disease occurrence
Individual lifestyle factors
Characteristics of the individual, including knowledge, attitudes, beliefs, and personality traits, as well as age, sex, and hereditary factors.
Social and community networks:
Points at which interaction with other individuals occurs. This sphere of influence can further be divided into the following levels:
Interpersonal
Family, friends, and peers who shape social identity, support, and roles.
Institutional/organizational
Rules and regulations of institutions, such as schools and places of employment, which may limit or promote healthy behavior.
Community
Comprises informal and formal social networks and norms formed among indi- viduals, groups, and organizations, including cultural and religious practices.
Shaping norms
Certain behaviors may become generally accepted among social groups. An attitude of “everyone else is doing it” can have a strong influence on an individual’s decision to partake in the activity. For example, in some communities, perhaps it is rare for anyone to wear a helmet while biking. So an individual who has always used a bicycle helmet in the past may decide to forego it because nobody else wears one in his new community.
Enforcing patterns of social control
Having rules and regulations in place creates structure for society, which can affect health. For instance, having a curfew for teenagers to be off the streets by midnight unless accompanied by an adult may assist in preventing violence.
Providing opportunities to engage in healthy behaviors
The opportunities, or lack thereof, in our surroundings can have a strong influence on our health. For instance, having access to a community pool can encourage individuals to learn to swim, thus preventing drowning, while also serving as a form of physical exercise and social cohesion.
Encouraging selection of healthy behaviors as a coping strategy
For example, college students often go through stressful periods throughout their academic career, particularly around exam time. Some students may decide to cope with this stress by “blowing off steam.” This can take many forms, from binge drinking to going for a run, each selection having a different effect on health.
Living conditions
Increases in sanitation, reductions in crowding, methods of heating and cooking
Overall educational opportunities
Education has the strongest association with health behaviors and health outcomes
May be due to better appreciation of factors associated with disease and greater ability to control these factors
Educational opportunities for women
Education for women has an impact on the health of children and families
Occupational exposures
Lower socioeconomic jobs are traditionally associated with increased exposures to health risks
Access to goods and services
Ability to access goods, such as protective devices, and high-quality foods and services, including medical and social services to protect and promote health
Family size
Large family size affects health and is traditionally associated with lower socioeconomic status and lower health status
Exposures to high-risk behaviors
Social alienation related to poverty may be associated with violence, drugs, and other high-risk behaviors
Environmental
Lower socioeconomic status is associated with greater exposure to environmental pollution, “natural” disasters, and dangers of the “built environment”
Culture is related to behavior—social practices may put individuals and groups at increased or reduced risk
Food preferences— vegetarian, Mediterranean diet Cooking methods History of binding of feet in China Female genital mutilation
Role of exercise
Culture is related to response to symptoms, such as the level of urgency to recognize symptoms, seek care, and communicate symptoms
Cultural differences
in seeking care and self-medication
Social, family, and work structures provide varying degree of social support—low degree of social support may be associated with reduced health-related quality
of life
Culture is related to the types of interventions that are acceptable
Variations in degree of acceptance of traditional Western medicine, including reliance on self-help and traditional healers
Culture is related to the response to disease and to interventions
Cultural differences in follow-up, adherence to treatment, and acceptance of adverse outcome
Religion may affect social practices that put individuals at increased or reduced risk
Sexual: circumcision, use of contraceptives Food: avoidance of seafood, pork, beef Alcohol use: part
of religion versus prohibited
Tobacco use: actively discouraged by Mormons and Seventh- Day Adventists as part of their religion
Religion may affect the response to symptoms
Christian Scientists reject medical care as a response to symptoms
Religion may affect the types of interventions that are acceptable
Prohibition against blood transfusions
Attitudes toward stem cell research
Attitudes toward abortion
End-of-life treatments
Religion may affect the response to disease and to interventions
Role of prayer as an intervention to alter outcome
10 Key Categories of Social Determinants of Health
Social Status
Social Support/Alienation
Food
Housing
Education
Work
Stress
Transportation
Place
Access to Health Services
Downstream factors
Those that directly involve an individual and can potentially be altered by individual interventions, such as an addiction to nicotine
Mainstream factors
Those that result from the relationship of an individual with a larger group or population, such as peer pressure to smoke or the level of taxation on cigarettes.
Upstream factors
Are often grounded in social structures and policies, such as government-sponsored programs that encourage tobacco production. These require us to look beyond traditional healthcare and public health interventions to the broader social and economic forces that affect health.
Perceived susceptibility
An individual’s opinion of getting a condition
Perceived severity
An individual’s opinion of how serious a condition is and its consequences
Perceived benefits
An individual’s belief in the advised action to reduce risk and/or severity of condition
Perceived barriers
An individual’s belief about the costs (tangible and psychological) of the advised action
Modifying variables
Individual characteristics that influence personal perceptions
Cues to action
Strategies/events that encourage one’s “readiness” to act
Self-efficacy
Belief in one’s ability to take action
Precontemplation
Individual not considering change
Prognosticate
Assessing readiness for change— timing is key
Contemplation
Individual thinks actively about the health risk and action required to reduce that risk
Issue of change is on the individual’s agenda but no action is planned
Motivate change
Provide information focused on short and intermediate gains from behavioral change, as well as long- term benefits
Doubtful, dire, and distant impacts are less effective
Preparation
Prepare for action, including developing a plan and setting a timetable
Plan change
Set specific measurable and obtainable goals with deadlines
2 or more well-chosen simultaneous interventions may maximize effectiveness
Recognize habitual nature of existing behavior and remove associated activities
Action
Observable changes in behavior with potential for relapse
Reinforce change
Provide/suggest tangible rewards
Positive feedback and encouragement of new behavior Anticipate adverse effects and frustrations
Utilize group/peer support
Maintenance
New behavior needs to
be consolidated as part of permanent lifestyle change
Maintain change
Practice/reinforce methods for maintaining new behavior
Recognize long-term nature of behavioral change and need for supportive peers and social reinforcement
reciprocal determinism
the dynamic interplay among per- sonal factors, the environment, and behavior
Social Cognitive Theory
Changing behavior requires an understanding of:
■ Individual characteristics, such as knowledge, skills, and beliefs
■ Influences in the social and physical environment, such as peer influence, level of family support, characteristics of the neighborhood, and work and school environments that help or hinder opportunities for health
■ Interaction among all these factors
Self-efficacy
Belief in one’s ability to take action
Observational learning (modeling)
Learning by watching others
Expectations
The likely outcome of a particular behavior
Expectancies
The value placed on the outcome of the behavior
Emotional arousal
Emotional reaction to a situation
Behavioral capability
Knowledge and skills needed to engage in a behavior
Reinforcement
Rewards or punishments for performing a behavior
Locus of control
One’s belief regarding one’s personal power over events
Knowledge
Before people can adopt an innovation, they must know it exists. Communication channels, such as media, friends, family members, and physicians, are influential in this stage.
Persuasion
In the persuasion stage, people develop an opinion about the innovation. That opinion may be positive or negative. The perceived characteristics of the innovation are particularly influential in the persuasion stage.
Decision
During the decision stage, people decide to either adopt or reject an innovation.
Implementation
During the implementation stage, an innovation is tried.
Confirmation
During the confirmation stage, support is sought for the decision, so that there is continued adoption, continued rejection, later adoption, or discontinuance of the innovation.
4 Ps of Social Marketing
Product
Price
Place
Promotion
Product
Identifying the behavior or innovation that is being marketed
Price
Identifying the benefits, the barriers, and the financial costs
Place
Identifying the target audiences and how to reach them
Promotion
Organizing a campaign or program to reach the target audience(s)
Promotion
Organizing a campaign or program to reach the target audience(s)
