These slides contain the lecture content for week 3.

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Week 3 Lecture
Instructor: Gina Crosley-Corcoran, MPH
PBH 715 – Introduction to Social &
Behavioral Sciences

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BEHAVIORAL AND SOCIAL
SCIENCE THEORY

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Introduction
 In this section, we will discuss the differences
between theories and models, identify examples of
these theories and models at multiple levels and
apply these to public health issues.
 Four broad theoretical traditions
 Social ecology
 Health promotion
 Interpretive studies
 Critical perspectives

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Theory vs Model
Theory
• Set of interrelated concepts,
constructs, and propositions
that predict behaviors
• Tend to encompass a broad
domain
• More formal
• Multiple theories may be
used to explain a
behavior/set of behaviors at
different levels
Model
• A heuristic device for
organizing components of a
domain to show
relationships between parts
and the outcome
• Applied to more narrowly
defined domains or
behaviors
• Less formal
• Make tentative claims about
causality

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Theoretical Traditions in Public Health
• Based upon the traditional public health model (host-agent
environment)
• Expanded to include social and cultural factors as key contributors to
health issues
• Social Ecology of Health Model
Social ecology
• Seeks to identify determinants and pathways of influence for
• health-related behaviors
• Focus on individual-level behavior change
• Key construct is self-efficacy
• Health Belief Model, Theory of Planned Behavior, Transtheoretical
Model
Health promotion

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Theoretical Traditions in Public Health
• Focus on subjective, perceptual, and cognitive dimensions of illness
• Meanings are not correct/incorrect and can change based upon
cognitive/social/cultural factors influencing the individual
• Qualitative approach often using illness narratives
• Theories from anthropology, sociology, psychology
Interpretive studies
• Challenge the dominant paradigms of public health practice and
seek alternative approaches to improve health
• Two approaches: political-economic and constructivist
• Argue that ecological models accept the social status quo and do
not challenge unequal distribution of resources
Critical perspectives

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Key Concepts of Theories and Models
Knowledge and attitudes
• Perceptions, attributions, attitudes, knowledge
• Cognitive factors are easy to study and typically straightforward
Health behavior
• Development of reliable and valid measures of specific health behaviors or prediction
of behaviors
• Often conceptualized according to different stages of behavior
Culture
• Explores differences across not only health states but explanations for health/illness
behaviors and perceptions
Social environment
• Social stress, social support, social networks, social capital

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Intrapersonal-Level Models
Cognitive models that focus on knowledge, attitudes, and
perceptions
Health Belief Model
• Decisions to take action are
based upon four factors:
perceived susceptibility,
perceived severity,
perceived benefits,
perceived barriers
Theory of Planned Behavior
• Intentional behavior is
determined by three
factors: attitude toward
the behavior, subjective
social norms, perceived
behavioral control

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Intrapersonal-Level Models
Transtheoretical Model
• Stage model of behavior
change
• People move through
stages of decision-making
from precontemplation
to adoption of the health
behavior change
Self-Regulatory Models
• Refers to the way in
which people monitor
their behavior and
continually make changes
to “regulate” their
actions to achieve goals
• Attempts to explain the
factors that are important
in this process

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Interpersonal-Level Models
Models and frameworks for understanding how social
context influences health
Social Support Theory
• Seeks to explain the
process of assistance
provided through
human relationships
Social Cognitive Theory
• Describes how social
relationships
influence cognitions
and behavior in a
reciprocal interaction

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Organizational-Level Models
 Aids in understanding how complex public health
agencies work and is useful in trying to plan programs
involving these entities
 Diffusion of Innovation Theory
 New behaviors tend to be adopted in predictable stages that
have predictable patterns
 Utilizes defined “types of adopters” to describe these
patterns

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Multi-Level Models
 Address distal, intermediate, and proximate factors
 Critical for understanding all types of health problems
and for analysis of public health issues
 Biopsychosocial Model
 Designed to explain the interplay of biological and social
factors in disease etiology
 Includes “layers” from genetic to global systems level
 While similar to the social ecology model, places greater
emphasis on the biological basis of disease

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HEALTH AND ILLNESS BEHAVIOR

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Definitions of Health and Illness Behavior
Health Behavior
• Actions taken in the absence of observable illness
• Includes primary prevention such as diet and exercise
Illness Behavior
• Designates help-seeking behavior
• Includes consulting with health-care providers and
engaging in self-care activities

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Theories
 Historical Behaviorist Theories
 Attempts at understanding human behavior may have
originated with Hippocrates
 Believed that behaviors corresponded to an over abundance
of humors (blood, black bile, yellow bile, phlegm)
 Behaviorist Theories
 Ivan Pavlov (1927) credited with identifying origins of human
behavior
 B.F. Skinner (1957) theory of “operating conditioning” –
pairing a targeted behavior with reinforcement

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Theories
 Cognitive Theories
 “personal thought processes that serve as frames of
reference for organizing and evaluating experiences” –
Gochman 1988, p 21
 Social Cognitive Theory
 Idea that many of our thoughts and believes are rooted in
observational learning experiences that have occurred in our
environment
 Focus: behavior modeling


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Week 3 Assignments
Discussion Board
Plagiarism Quiz
Live Book Discussions