hbhe600 2008 01 intro measurement

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UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH

HBHE 600: PsychosocialFactors in Health-Related Behavior

Victor J. Strecher, PhD

Professor, HBHE

School of Public Health

University of Michigan


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Introduction Course Syllabus

Description

Objectives

Flow

Readings

Grading

Academic conduct

Diversity issues

Why were here


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HBHE 600 provides an overview of the

social-psychological determinants of

behavioral risk factors that affect health.

We address these determinants within

conceptual frameworks and models of

health-related behavior. These

determinants are the building blocks of

intervention and program planning.

HBHE 600 DESCRIPTION


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HBHE 600 OBJECTIVES

By the end of the course, participants

should have a general understanding of:

1. THE MAJOR PSYCHOSOCIAL MODELS AND THEORIES USED

IN THE FIELD OF HEALTH BEHAVIOR AND HEALTH

EDUCATION

2. THE ROLE OF PSYCHOSOCIAL FACTORS IN PREDICTING A

RANGE OF HEALTH-RELATED BEHAVIORS

3. USING PSYCHOSOCIAL MODELS AND DETERMINANTS TO

DEVELOP A CONCEPTUAL FRAMEWORK OF HEALTH

BEHAVIOR CHANGE

4. INTERVENTIONS TO CHANGE PSYCHOSOCIAL

DETERMINANTS


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HBHE 600 FLOWTheory

Determining andmeasuring relevant

psychosocial factors

Health Belief Model

Theory of Reasoned Action

Theory of Planned Behavior

Social Cognitive Theory

Transtheoretical Model

Self-Determination Theory

Chaos Theory

Motivational Interviewing

Behavior Modification

Goal TheorySocial Support

Elaboration Likelihood Model

Cognitive Load Theory

Cognitive Schema

Building conceptual

frameworks for health-

related behavior.


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HBHE 600 READINGS

In HBHE 600 CourseTools


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Mid-term exam (40%)

Final exam (60%)

HBHE 600 GRADING

Content of the examinations will come from

class lectures and the required readings.



HBHE 600 ACADEMIC CONDUCT

Students should expect faculty and

graduate assistants to treat them fairly,

showing respect for their ideas and

opinions and striving to help them achieve

maximum benefits from their experience

in the School of Public Health.

Similarly, courtesy, honesty, and respect

should be shown by students towardfaculty, graduate assistants, and fellow

students.



HBHE 600 ACADEMIC CONDUCT

Student academic misconduct refers to

behavior that may include plagiarism,

cheating, fabrication, falsification of

records or official documents, and aidingand abetting the perpetration of such

acts. Preparation of the mid-term and

final examinations must represent each

students own effort.



HBHE 600 DIVERSITY ISSUES

Language

Culture

Background1st /2nd /3rd generation college?

Comfortable speaking up, asking questions?

Is class a comfort zone or an alien environment?



Heart disease

Cancer

Cerebrovasc. disease

Unintentional injuries

Chronic lung disease

Pneumonia/ Influenza

Diabetes

Suicide

Chronic liver diseaseHIV infection

720,058

505,322

144,088

91,98386,679

79,513

47,664

30,90625,188

1,757,188

Cause Estimated #

Deaths

10 leading causes of death in the United States

McGinnis JM, Foege WH. Actual causes of death in the United States. JAMA. Vol 270, #18, 1993.



400,000

300,000

100,00090,000

60,000

35,000

30,000

25,000

20,000

1,060,000

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10 Priorities of Nations 2010 Objectives

Physical activity Overweight and obesity

Tobacco use

Substance abuse

Responsible sexual

behavior

Mental health Injury and violence

Environmental quality

Immunization

Access to health care



"Even our most conservative estimate indicates that reductions in lung

cancer, resulting from reductions in tobacco smoking over the last halfcentury, account for about 40% of the decrease in overall male cancer

death rates and have prevented at least 146 000 lung cancer deaths in

men during the period 1991 to 2003. A more realistic straight line

projection of what lung cancer rates might have become suggests that,

without reductions in smoking, there would have been virtually no

reduction in overall cancer mortality in either men or women sincethe early 1990s. The payoff from past investments in tobacco controlhas only just begun. The aging of birth cohorts with lower smokinginitiation rates and the anticipated future decrease in lung cancer

mortality in women will help to sustain progress."

Michael Thun, American Cancer Society

Tobacco Control



(*BMI 30, or ~ 30 lbs. overweight for 5 4 person)

Obesity Trends* Among U.S. AdultsBRFSS, 1985

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Ecological Perspectives on Health

Promotion

Examine the joint or cumulative effects of personaland environmental factors in designing health

promotion programs.

Take into account linkages between various settingsand levels, and how change at one level affects

others.


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Individual vs. Social Responsibility

No one would question that, as individuals, we are responsible for

our health. In the final analysis, we are the only ones who canchange our behavior. We are the only ones who lift fork to mouth,

who inhale smoke, who plant feet on sidewalk. And we are the

only ones who can decide to do these things[But] we dont live ina vacuum. Whether we like it or not, our thoughts, ideas, wishes

and behaviors are influenced and conditioned by the people aroundus, by the environments in which we find ourselves, and by the

customs, traditions, fads and fashions to which we are continuously

exposedEffective behavior change therefore requires that we do

our best as individuals, but also that we work together with one

another to create more healthful and supportive socialenvironments.

S. Leonard Syme


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Theories

Determining and

measuring

psychosocial

constructs in

theories

Wh t i th ?


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Definitions

Characteristics

Concepts, Constructs, and Variables

What is a theory?


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Definitions of Theory

A set of interrelated constructs, definitions, and propositionsthat presents a systematic view of phenomena by specifyingrelations among variables, with the purpose of explaining andpredicting phenomena. (Kerlinger, 1986, p. 9)

A systematic explanation for the observed facts and laws that

relate to a particular aspect of life. (Babbie, 1989, p. 46)

An abstract, symbolic representation of what is conceived tobe realitya set of abstract statements designed to fit someportion of the real world. (Zimbardo, Ebbesen, & Maslach,1977, p. 5)


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General - broad application

Abstract - not specified in detail

Testable - you can measure constructs

Replicable - can be tested again and again

Characteristics of Theory


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Concepts - major components or ideas of a theory

Constructs - when concepts have been developed for

use in a particular theory, they are called constructs.

Variables - are the operational form of constructs.

They specify how a construct is to be measured in a

specific situation.

Concepts, constructs, and variables


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Theories can tell you

WHY people are or are not engaging in health-related behaviors.

WHAT needs to be evaluated to demonstrateprogram or policy effectiveness.

HOW to shape program strategies to reach peopleand organizations.*

*Though most psychosocial theories of health-relatedbehavior dont do this.


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How do we create, examine, test theories?


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Surveying

Observing

From: OLeary, Z. (2004) The Essential Guide to Doing Research. London: Sage Chapter Eleven.


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Survey

Survey (noun): Information gathered by askinga range of individuals the same questionsrelated to their characteristics, attributes,how they live, or their opinions

Survey (verb): The process ofcollecting such

information



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Basic Survey Types

Surveys can also involve populations or samples of

populations:

Census: This is a survey that does not rely on a

sample. A census surveys every single person ina defined or target population

Cross-sectional surveys: This type of survey

uses a sample or cross-section of respondentsselected to represent a target population



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Basic Survey Types

Surveys can capture a moment or map trends:

Trend surveys: A trend survey asks similar groupsof respondents, or the same cross-section, the

same questions at two or more points in time

Panel study: A panel study involves asking thesame (not similar) sample of respondents the same

questions at two or more points in time



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Basic Survey Types

Surveys can be administered in lots of ways:

Face to face

Telephone

Self-administered

Now the Web!



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Interview Types

Interviews can range from fixed to free: Structured: Uses pre-established questions, asked in a

predetermined order, using a standard mode of delivery

Semi-structured: As the name suggests, these interviews

are neither fully fixed nor fully free, and are perhaps bestseen as flexible

Unstructured:Attempts to draw out information,attitudes, opinions, and beliefs around particular themes,

ideas, and issues without the aid of predeterminedquestions



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Self-efficacy Example:

When I feel stressed

After I have just finished a meal

While drinking coffee with friends

When I feel sad or lonely

While talking on the telephone

When I am around people who are smoking

When I feel angry or frustrated

When I am happy and feel like celebrating

While driving

When I feel nervous or anxious

When I am bored

When at a bar or a party

Please rate how confident you are that you can keep from smoking cigarettes in the following situations:

Not at allconfident

Extremelyconfident

1 2 3 4 5

O

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Motives

The medication is good for my diabetes. I feel guilty if I dont take my meds.

Its an important choice that I make for myself.

Ive seen what diabetes has done for others.

I like the challenge of taking responsibility for my health. My family and/or friends get upset with me if I dont take my meds.

I want to be in charge of my diabetes.

My physician gets upset with me if I dont take my meds.

It is consistent with my goals of taking control of my diabetes. I can avoid or delay getting other health problems if I take my meds.

I want to set a good example for others.


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Motives

The medication is good for my diabetes. I feel guilty if I dont take my meds.

Its an important choice that I make for myself.

Ive seen what diabetes has done for others.

I like the challenge of taking responsibility for my health. My family and/or friends get upset with me if I dont take my meds.

I want to be in charge of my diabetes.

My physician gets upset with me if I dont take my meds.

It is consistent with my goals of taking control of my diabetes. I can avoid or delay getting other health problems if I take my meds.

I want to set a good example for others.

Intrinsic Extrinsic


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Validity of self-reported data:

In some cases validity varies by demographiccharacteristics

More important are:

Surroundings

Person or thing asking the question

How the question is asked

The questions preceding the question


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Surveying

Observing



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Types of Observation Observational techniques can range from highly

structured to unstructured.

Structured: Highly systematic and often rely on predeterminedcriteria related to the people, events, practices, issues, behaviors,actions, situations, and phenomena being observed.

Semi-structured: Observers generally use some manner ofobservation schedule or checklist to organize observations, but alsoattempt to observe and record the unplanned and/or the unexpected.

Unstructured:Observers attempt to observe and record data without

predetermined criteria.

F OL Z (2004) Th E i l G id D i R h L d S Ch El

hbhe600 2008 01 intro measurement

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