Here is a research tip: We write the theory into a separate section in a research proposal so that readers can clearly identify the theory from other components. Such a separate passage provides a complete explication of the theory section, its use, and how it relates to the study.
Writing a Quantitative Theoretical Perspective
Using these ideas, the following presents a model for writing a quantitative theoretical perspective section into a research plan. Assume that the task is to identify a theory that explains the relationship between independent and dependent variables.
Look in the discipline-based literature for a theory. If the unit of analysis for variables is an individual, look in the psychology literature; to study groups or organizations, look in the sociological literature. If the project examines individuals and groups, consider the social psychology literature. Of course, theories from other disciplines may be useful, too (e.g., to study an economic issue, the theory may be found in economics).
Examine also prior studies that address the topic or a closely related topic. What theories did the authors use? Limit the number of theories and try to identify one overarching theory that explains the central hypothesis or major research question.
As mentioned earlier, ask the rainbow question that bridges the independent and dependent variables: What explains why the independent variable(s) would influence the dependent variables?
Script out the theory section. Follow these lead sentences: “The theory that I will use is _____ (name the theory). It was developed by _____ (identify the origin, source, or developer of the theory), and it was used to study _____ (identify the topics where one finds the theory being applied). This theory indicates that _____ (identify the propositions or hypotheses in the theory). As applied to my study, this theory holds that I would expect my independent variable(s) _____ (state independent variables) to influence or explain the dependent variable(s) _____ (state dependent variables) because _____ (provide a rationale based on the logic of the theory).”
Thus, the topics to include in a quantitative theory discussion are the theory to be used, its central hypotheses or propositions, information about past use of the theory and its application, and statements that reflect how it relates to a proposed study. Example 3.1, which contains a passage by Crutchfield (1986) from her dissertation, illustrates the use of this model.
Theory
at a
Glance
A Guide For Health Promotion Practice
(Second Edition)
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health
Foreword
A
decade ago, the first edition of Theory at a Glance was published. The guide was
a welcome resource for public health practitioners seeking a single, concise
summary of health behavior theories that was neither overwhelming nor superficial.
As a government publication in the public domain, it also prov ...
This document provides an introduction and overview of Theory at a Glance: Application to Health Promotion and Health Behavior (Second Edition). It discusses the importance and role of theory in health promotion practice. The document is intended to help public health workers and practitioners design effective programs by applying relevant behavioral theories. It contains three parts, with Part 1 providing foundations on the use of theory in health promotion. Theories can help explain health behaviors, identify factors that influence behavior and how they may be changed, and guide the development and evaluation of health interventions and programs. Both explanatory and change theories are important. The document emphasizes that no single theory is suitable for all cases and that practitioners should select theories appropriate for the issue, population, and context.
National Institute of Health: Theory at a Glance, A Guide for Health Promotio...Zach Lukasiewicz
Introduction viii
Audience and Purpose 1
Contents 1
Part 1: Foundations of Theory in Health Promotion and Health Behavior 3
Why Is Theory Important to Health Promotion and Health Behavior Practice? 4
What Is Theory? 4
How Can Theory Help Plan Effective Programs? 4
Explanatory Theory and Change Theory 5
Fitting Theory to the Field of Practice 5
Using Theory to Address Health Issues in Diverse Populations 7
Part 2: Theories and Applications 9
The Ecological Perspective: A Multilevel, Interactive Approach 10
Theoretical Explanations of Three Levels of Influence 12
Individual or Intrapersonal Level 12
Health Belief Model 13
Stages of Change Model 15
Theory of Planned Behavior 16
Precaution Adoption Process Model 18
Interpersonal Level 19
Social Cognitive Theory 19
Community Level 22
Community Organization and Other Participatory Models 23
Diffusion of Innovations 27
Communication Theory 29
Media Effects 30
Agenda Setting 30
New Communication Technologies 31
Following on from the success of the second edition, 'Theory in a Nutshell 3e' explores the main theoretical concepts and models in health promotion and explains the significance, practical application and impact of different theories on the individual, community and organisation. This edition includes concise reviews of established theories, such as social cognitive theory and health belief model, as well as expanding on new developments in the field including evidence-based policy making and health impact assessment. Thoroughly revised and updated, the book maintains the accessible style suitable for public health practitioners, health promotion and health education specialists, epidemiologists and social policy makers, as well as students of public health and health promotion.
The Duty of Loyalty and Whistleblowing Please respond to the fol.docxcherry686017
"The Duty of Loyalty and Whistleblowing" Please respond to the following:
· Analyze the duty of loyalty in whistleblower cases to determine to whom loyalty is owed and who shows the greater duty of loyalty. Support your analysis with specific examples. Then, suggest at least one (1) change to an existing law.
· Reexamine the Citizens United decision in Chapter 1, and determine which of the following groups has the greatest free speech rights: corporations, public employees, or private employees. Provide a rationale for your determination.
11 Combining Research Methods: Case Studies and Action Research
Rebecca Jester
Introduction
In Chapters 7 and 8, we focused on the unique features of quantitative and qualitative research. In this chapter, we aim to demonstrate how research methods can be integrated and combined to address specific research questions. The chapter will provide an overview of two specific research designs: action research and case studies, together with examples from research projects conducted by the author. This chapter does not aim to provide an in-depth philosophical debate related to case study and action research approaches, but rather a practical discussion of the merits, limitations and application of these two approaches. We begin by discussing the concepts of ‘mixed methods’ and ‘triangulation', first introduced in Chapter 2.
Mixed methods approaches
Traditionally, within health and social research, individuals have aligned themselves with either the quantitative or qualitative paradigm. However, in reality, many real world research projects benefit from mixing or combining methods. Mixed methods research can be accomplished either by using specific approaches to research, such as action research or case study, as discussed within this chapter, or by adopting a phased approach within a study. This might involve the first stage being exploratory within the qualitative paradigm, and the results from this being used to form specific hypotheses for testing within an experimental design, such as a randomized controlled trial. Equally, a quantitative approach (say, a questionnaire) might be used to gather data from a wide range of people, with the results being used to develop a qualitative interview schedule for use with a small sample of respondents.
Triangulation
Very often a research study is undertaken with multiple datasets, mixed methodology or with different researchers, such as at different sites. Triangulation is a very useful technique that enables you to enhance and verify concepts. As Ramprogus (2005, p. 4) suggests, ‘triangulation … tries to reconcile the differences of two or more data sources, methodological approaches, designs, theoretical perspectives, investigators and data analysis to compensate for the weaknesses of any single strategy towards achieving completeness or confirmation of findings’. However, triangulation must be exercised with caution; it is no substitute for robust and well-established ...
KEYSTONE HPSR Initiative // Module 7: Realist evaluation // Slideshow 1: Realist and theory driven approaches in HPSR
This is the only slideshow of Module 7: Realist evaluation, of the KEYSTONE Teaching and Learning Resources for Health Policy and Systems Research
To access video sessions and slides for all modules copy and past the following link in your browser:
http://bit.ly/25vVVp1
Module 7: Realist evaluation
Programmes and policies are complex in their design and implementation because of the number of interacting agents, components and forces that influence people and organisations in a given system. In this module through the realist evaluation approach explores why programmes/interventions work for some and not for others and getting to the core issue of trying to understand the conditions under which the interventions works.
There is 1 slideshow in this module.
Module 7: Realist evaluation
Module 7 Slideshow 1: Realist and theory- driven approaches in HPSR
The other modules in this series are:
Module 1: Introducing Health Systems & Health Policy
Module 2: Social justice, equity & gender
Module 3: System complexity
Module 4: Health Policy and Systems Research frameworks
Module 5: Economic analysis
Module 6: Policy analysis
Module 8: Systems thinking
Module 9: Ethnography
Module 10: Implementation research
Module 11: Participatory action research
Module 12: Knowledge translation
Module 13: Research Plan Writing
KEYSTONE is a collective initiative of several Indian health policy and systems research (HPSR) organizations to strengthen national capacity in HPSR towards addressing critical needs of health systems and policy development. KEYSTONE is convened by the Public Health Foundation of India in its role as Nodal Institute of the Alliance for Health Policy and Systems Research (AHPSR).
The inaugural KEYSTONE short course was conducted in New Delhi from 23 February – 5 March 2015. In the process of delivering the inaugural course, a suite of teaching and learning materials were developed under Creative Commons license, and are being made available as open access resources. The KEYSTONE teaching and learning resources include 38 videos and 32 slide presentations organized into 13 modules. These materials cover foundational concepts, common approaches used in HPSR, and guidance for preparing a research plan.
These resources were created and are made available through support and funding from the Alliance for Health Policy & Systems Research (AHPSR), WHO for the KEYSTONE initiative.
Assignment 3 Policy Analysis Paper In previous Discussion.docxluearsome
Assignment 3: Policy Analysis Paper
In previous Discussions and Assignments, you have examined various aspects of the policy process: exploring the unintended consequences of policies, agenda setting, and analyzing policy recommendations. In this Assignment, you will have the opportunity to further develop your analysis skills by working through the policy analysis process. To be an effective agent for social change, you must be able to logically and critically analyze policy from multiple perspectives and contexts and then present your insights in a succinct and professional manner. This exercise will afford such an experience.
For this Assignment, you will examine a particular policy of interest to you (perhaps the one you selected for this week's Discussion) and apply a policy analysis framework to understand the impact associated with the implementation of the policy. You will then develop a policy analysis paper, which is due day 5 of Week 11. This paper will also serve as your Major Assessment for this course.
To prepare:
Select a health care policy and a policy analysis framework to utilize for this Assignment. You may use the policy and framework you identified in this week’s Discussion or change your selection.
To complete:
Write an 8- to 10-page analysis paper (including references) in which you succinctly address the following:
1) An introduction
2)
Part 1: Define the policy issue.
a) How is the issue affecting the policy arena?
b) What are the current politics of the issue?
c) At what level in the policy making process is the issue?
3)
Part 2: Apply a policy analysis framework to explore the issue using the following contexts:
a) Social
b) Ethical
c) Legal
d) Historical
e) Financial/economic
f) Theoretical underpinnings of the policy
Include in this section:
a) Who are the stakeholders of interest?
b) Is there a nursing policy/position statement on this health care issue? If so, who developed it?
4)
Part 3: Policy options/solutions
a) What are the policy options/solutions for addressing the issue? Include at least three levels of options/solutions: no change; partial change; radical change or maximum change.
b) What are the theoretical underpinnings of the policy options/solutions?
c) What are the health advocacy aspects and leadership requirements of each option?
d) How does each option/solution provide an opportunity or need for inter-professional collaboration?
e) What are the pros and cons of each suggested change? Include the cost benefits, effectiveness, and efficiency of each option along with the utility and feasibility of each option.
5)
Part 4: Building Consensus
a) Outline a plan for building consensus around your recommended option/solution for solving the policy issue.
6) A Conclusion
7)
Part 5: References
a) Limit your references so this section is no more than 2 pages.
Your written assignments must follow APA guidelines. Be sure to support your work with ...
Implementation science studies strategies for adapting and applying evidence-based interventions in real-world settings like schools, workplaces and healthcare facilities to improve population health. This field develops theories of implementation and evaluates measures of implementation success. Methods include stakeholder engagement, effectiveness studies, research synthesis and modeling to identify strategies for integrating evidence-based interventions into programs and policies. For implementation science to reach its full potential, the research paradigm needs to shift toward greater stakeholder input and reporting on external validity to improve relevance and guide decision makers.
This document provides an introduction and overview of Theory at a Glance: Application to Health Promotion and Health Behavior (Second Edition). It discusses the importance and role of theory in health promotion practice. The document is intended to help public health workers and practitioners design effective programs by applying relevant behavioral theories. It contains three parts, with Part 1 providing foundations on the use of theory in health promotion. Theories can help explain health behaviors, identify factors that influence behavior and how they may be changed, and guide the development and evaluation of health interventions and programs. Both explanatory and change theories are important. The document emphasizes that no single theory is suitable for all cases and that practitioners should select theories appropriate for the issue, population, and context.
National Institute of Health: Theory at a Glance, A Guide for Health Promotio...Zach Lukasiewicz
Introduction viii
Audience and Purpose 1
Contents 1
Part 1: Foundations of Theory in Health Promotion and Health Behavior 3
Why Is Theory Important to Health Promotion and Health Behavior Practice? 4
What Is Theory? 4
How Can Theory Help Plan Effective Programs? 4
Explanatory Theory and Change Theory 5
Fitting Theory to the Field of Practice 5
Using Theory to Address Health Issues in Diverse Populations 7
Part 2: Theories and Applications 9
The Ecological Perspective: A Multilevel, Interactive Approach 10
Theoretical Explanations of Three Levels of Influence 12
Individual or Intrapersonal Level 12
Health Belief Model 13
Stages of Change Model 15
Theory of Planned Behavior 16
Precaution Adoption Process Model 18
Interpersonal Level 19
Social Cognitive Theory 19
Community Level 22
Community Organization and Other Participatory Models 23
Diffusion of Innovations 27
Communication Theory 29
Media Effects 30
Agenda Setting 30
New Communication Technologies 31
Following on from the success of the second edition, 'Theory in a Nutshell 3e' explores the main theoretical concepts and models in health promotion and explains the significance, practical application and impact of different theories on the individual, community and organisation. This edition includes concise reviews of established theories, such as social cognitive theory and health belief model, as well as expanding on new developments in the field including evidence-based policy making and health impact assessment. Thoroughly revised and updated, the book maintains the accessible style suitable for public health practitioners, health promotion and health education specialists, epidemiologists and social policy makers, as well as students of public health and health promotion.
The Duty of Loyalty and Whistleblowing Please respond to the fol.docxcherry686017
"The Duty of Loyalty and Whistleblowing" Please respond to the following:
· Analyze the duty of loyalty in whistleblower cases to determine to whom loyalty is owed and who shows the greater duty of loyalty. Support your analysis with specific examples. Then, suggest at least one (1) change to an existing law.
· Reexamine the Citizens United decision in Chapter 1, and determine which of the following groups has the greatest free speech rights: corporations, public employees, or private employees. Provide a rationale for your determination.
11 Combining Research Methods: Case Studies and Action Research
Rebecca Jester
Introduction
In Chapters 7 and 8, we focused on the unique features of quantitative and qualitative research. In this chapter, we aim to demonstrate how research methods can be integrated and combined to address specific research questions. The chapter will provide an overview of two specific research designs: action research and case studies, together with examples from research projects conducted by the author. This chapter does not aim to provide an in-depth philosophical debate related to case study and action research approaches, but rather a practical discussion of the merits, limitations and application of these two approaches. We begin by discussing the concepts of ‘mixed methods’ and ‘triangulation', first introduced in Chapter 2.
Mixed methods approaches
Traditionally, within health and social research, individuals have aligned themselves with either the quantitative or qualitative paradigm. However, in reality, many real world research projects benefit from mixing or combining methods. Mixed methods research can be accomplished either by using specific approaches to research, such as action research or case study, as discussed within this chapter, or by adopting a phased approach within a study. This might involve the first stage being exploratory within the qualitative paradigm, and the results from this being used to form specific hypotheses for testing within an experimental design, such as a randomized controlled trial. Equally, a quantitative approach (say, a questionnaire) might be used to gather data from a wide range of people, with the results being used to develop a qualitative interview schedule for use with a small sample of respondents.
Triangulation
Very often a research study is undertaken with multiple datasets, mixed methodology or with different researchers, such as at different sites. Triangulation is a very useful technique that enables you to enhance and verify concepts. As Ramprogus (2005, p. 4) suggests, ‘triangulation … tries to reconcile the differences of two or more data sources, methodological approaches, designs, theoretical perspectives, investigators and data analysis to compensate for the weaknesses of any single strategy towards achieving completeness or confirmation of findings’. However, triangulation must be exercised with caution; it is no substitute for robust and well-established ...
KEYSTONE HPSR Initiative // Module 7: Realist evaluation // Slideshow 1: Realist and theory driven approaches in HPSR
This is the only slideshow of Module 7: Realist evaluation, of the KEYSTONE Teaching and Learning Resources for Health Policy and Systems Research
To access video sessions and slides for all modules copy and past the following link in your browser:
http://bit.ly/25vVVp1
Module 7: Realist evaluation
Programmes and policies are complex in their design and implementation because of the number of interacting agents, components and forces that influence people and organisations in a given system. In this module through the realist evaluation approach explores why programmes/interventions work for some and not for others and getting to the core issue of trying to understand the conditions under which the interventions works.
There is 1 slideshow in this module.
Module 7: Realist evaluation
Module 7 Slideshow 1: Realist and theory- driven approaches in HPSR
The other modules in this series are:
Module 1: Introducing Health Systems & Health Policy
Module 2: Social justice, equity & gender
Module 3: System complexity
Module 4: Health Policy and Systems Research frameworks
Module 5: Economic analysis
Module 6: Policy analysis
Module 8: Systems thinking
Module 9: Ethnography
Module 10: Implementation research
Module 11: Participatory action research
Module 12: Knowledge translation
Module 13: Research Plan Writing
KEYSTONE is a collective initiative of several Indian health policy and systems research (HPSR) organizations to strengthen national capacity in HPSR towards addressing critical needs of health systems and policy development. KEYSTONE is convened by the Public Health Foundation of India in its role as Nodal Institute of the Alliance for Health Policy and Systems Research (AHPSR).
The inaugural KEYSTONE short course was conducted in New Delhi from 23 February – 5 March 2015. In the process of delivering the inaugural course, a suite of teaching and learning materials were developed under Creative Commons license, and are being made available as open access resources. The KEYSTONE teaching and learning resources include 38 videos and 32 slide presentations organized into 13 modules. These materials cover foundational concepts, common approaches used in HPSR, and guidance for preparing a research plan.
These resources were created and are made available through support and funding from the Alliance for Health Policy & Systems Research (AHPSR), WHO for the KEYSTONE initiative.
Assignment 3 Policy Analysis Paper In previous Discussion.docxluearsome
Assignment 3: Policy Analysis Paper
In previous Discussions and Assignments, you have examined various aspects of the policy process: exploring the unintended consequences of policies, agenda setting, and analyzing policy recommendations. In this Assignment, you will have the opportunity to further develop your analysis skills by working through the policy analysis process. To be an effective agent for social change, you must be able to logically and critically analyze policy from multiple perspectives and contexts and then present your insights in a succinct and professional manner. This exercise will afford such an experience.
For this Assignment, you will examine a particular policy of interest to you (perhaps the one you selected for this week's Discussion) and apply a policy analysis framework to understand the impact associated with the implementation of the policy. You will then develop a policy analysis paper, which is due day 5 of Week 11. This paper will also serve as your Major Assessment for this course.
To prepare:
Select a health care policy and a policy analysis framework to utilize for this Assignment. You may use the policy and framework you identified in this week’s Discussion or change your selection.
To complete:
Write an 8- to 10-page analysis paper (including references) in which you succinctly address the following:
1) An introduction
2)
Part 1: Define the policy issue.
a) How is the issue affecting the policy arena?
b) What are the current politics of the issue?
c) At what level in the policy making process is the issue?
3)
Part 2: Apply a policy analysis framework to explore the issue using the following contexts:
a) Social
b) Ethical
c) Legal
d) Historical
e) Financial/economic
f) Theoretical underpinnings of the policy
Include in this section:
a) Who are the stakeholders of interest?
b) Is there a nursing policy/position statement on this health care issue? If so, who developed it?
4)
Part 3: Policy options/solutions
a) What are the policy options/solutions for addressing the issue? Include at least three levels of options/solutions: no change; partial change; radical change or maximum change.
b) What are the theoretical underpinnings of the policy options/solutions?
c) What are the health advocacy aspects and leadership requirements of each option?
d) How does each option/solution provide an opportunity or need for inter-professional collaboration?
e) What are the pros and cons of each suggested change? Include the cost benefits, effectiveness, and efficiency of each option along with the utility and feasibility of each option.
5)
Part 4: Building Consensus
a) Outline a plan for building consensus around your recommended option/solution for solving the policy issue.
6) A Conclusion
7)
Part 5: References
a) Limit your references so this section is no more than 2 pages.
Your written assignments must follow APA guidelines. Be sure to support your work with ...
Implementation science studies strategies for adapting and applying evidence-based interventions in real-world settings like schools, workplaces and healthcare facilities to improve population health. This field develops theories of implementation and evaluates measures of implementation success. Methods include stakeholder engagement, effectiveness studies, research synthesis and modeling to identify strategies for integrating evidence-based interventions into programs and policies. For implementation science to reach its full potential, the research paradigm needs to shift toward greater stakeholder input and reporting on external validity to improve relevance and guide decision makers.
Discussion Introduction to Project ManagementConsider the fol.docxmickietanger
This document provides an introduction to applying project management methodology in healthcare settings. It lists skills important for both nursing and project management such as analytical thinking, organization, communication, and time management. The document discusses how these overlapping skills indicate that project management principles can benefit healthcare. It prompts readers to consider how to communicate the value of project management to nurses and motivate them to use related methods. Finally, it provides several required readings on applying project management in healthcare contexts.
Transitioning From Closed to Open Systems Week 4.docxwrite4
(1) The document discusses transitioning from a closed to an open systems perspective when addressing problems in healthcare organizations. (2) It provides an example of identifying an issue in one's organization and explaining it from a closed systems view that only considers internal factors. (3) An open systems view is then described which takes into account external influences and how collaboration could help address the problem and improve patient outcomes.
Health Promotion Model Free Essay Example. Health Promotion in the Workplace Essay Example | Topics and Well .... Health Promotion Essay On Diabetes - DiabetesWalls. Health Promotion Essay Example | Sitedoct.org.
This document provides an introduction and table of contents for a resource guide on implementation science. The guide aims to help decision makers and practitioners apply implementation science concepts to more effectively deliver evidence-based practices. The introduction defines implementation science as a way to close the gap between innovation and real-world practice. The table of contents previews sections on whether implementation is a science, common implementation models and frameworks, relevant research methods, and examples of applying implementation science in real-world settings. The resource guide is intended to connect readers with implementation science and facilitate more effective long-term use of specific evidence-based practices.
Don de Savigny: Systems Thinking Methodologies for Health Systems Research – ...Rebekah McKay-Smith
This document provides an introduction to systems thinking methodologies for health systems research. It discusses:
1) The need to consider the complexity of health systems rather than view them as simple linear models.
2) An overview of key concepts in systems thinking like complex adaptive systems, feedback loops, and leverage points for intervention.
3) Examples of applying systems thinking approaches to health systems research like network analysis, system dynamics modeling, and process mapping.
Looking at implementation: how useful is realist evaluation?valéry ridde
Presentation by Emilie Robert (McGill University).
Global Health Workshop: Methods For Implementation Science in Global Health.
http://www.equitesante.org/implementation-science-methods-in-global-health/
This document outlines the requirements for a scholar-practitioner project on public health leadership theory. It includes sections on an abstract and introduction, literature review and problem statement, personal leadership theory, visual representation of the theory, and an empirical evaluation plan. The literature review must synthesize 15-20 peer-reviewed sources and identify theoretical gaps. The problem statement must address the gaps and implications for social change. The personal leadership theory and visual representation must address the identified gaps. The evaluation plan must suggest how to assess if the new theory addresses the identified problem.
I need between 100-120 words for each assignment, and I want ind.docxflorriezhamphrey3065
I need between 100-120 words for each assignment, and I want individual references with each response. Please, no plagiarized work
Module 1
DQ 1
Outcome measures are significant in showing the worth of the Doctor of Nursing Practice's role in health care. Identify a practice-level outcome study or project and describe the expectation of its effect on health care. Which outcome measure do you think aligns with your DPI project (Quality Improvement Project)? Why? Provide examples and literature support.
DQ 2
In this week's readings, theories of accident causation, human error, foresight, resilience, and system migration were discussed. Identify a safety theory and propose quality measures to improve patient safety. Which theory or framework are you using to guide your DPI Project's intervention and outcome? Please define what constructs of your chosen DPI Project theory will help you change/improve clinical practice to improve a specific patient outcome? Provide examples and literature support.
Resources
Henneman, E. A. (2017). Recognizing the ordinary as extraordinary: Insight into the “way we work” to improve patient safety outcomes.
American Journal of Critical Care
,
26
(4), 272–277. doi:10.4037/ajcc2017812
Smith, S. A., Yount, N., & Sorra, J. (2017). Exploring relationships between hospital patient safety culture and Consumer Reports safety scores.
BMC Health Services Research
,
17,
1-9. doi:10.1186/s12913-017-2078-6
Module 2
DQ 1
Discuss economic methodology, including the concept of cost-based analysis. If you will not be addressing this in your DPI Project, provide an example of a program where it could be used to show outcomes. Provide examples and literature support.
DQ 2
Discuss a change theory and how it can be or has been applied in nursing practice to integrate care delivery sustainability. How will you use change theory in the design of your project to support the sustainability of your practice improvement intervention? Provide examples and literature support.
Resources
Uluskan, M., McCreery, J. K., & Rothenberg, L. (2018). Impact of quality management practices on change readiness due to new quality implementations.
International Journal of Lean Six Sigma
,
9
(3), 351-373. doi:10.1108/IJLSS-05-2017-0049
Steele Gray, C., Wilkinson, A., Alvaro, C., Wilkinson, K., & Harvey, M. (2015). Building resilience and organizational readiness during healthcare facility redevelopment transitions: Is it possible to thrive?
HERD: Health Environments Research & Design Journal
,
9
(1), 10-33. doi:10.1177/1937586715593552
Allen, B. (2016). Effective design, implementation and management of change in healthcare.
Nursing Standard
,
31
(3), 58. doi:10.7748/ns.2016.e10375
Module 3
DQ 1
New health care delivery models are being presented to accommodate the shift in health care objectives. Many of these models are community-based and focused on improving quality outcomes, population health, and reducing readmissions.
Reflective Journal Week 5Topic Philosophies and Theories for Ad.docxsodhi3
Reflective Journal Week 5
Topic: Philosophies and Theories for Advanced Nursing Practice
Course objective:
1. Examine disciplinary influences on nursing inquiry such as biology, medicine, psychology, sociology, and philosophy, among others.
2. Evaluate the application and adaptation of borrowed theories to nursing practice.
Discussion Question: 5 DQ 1
Learning theories have implications for advanced practice nurses outside the classroom. Share an example describing the application of learning theory or theories to develop a program targeting change to a specific organizational issue, patient lifestyle, or specific unhealthy behaviors.
Nursing education is essential to equip professionals with appropriate skills and competencies in line with the changing demands. In this regard, learning theories offer important guidelines for planning of an educational system within the clinical training. Two important areas highlighted in any theory include a change of behavior and talent development. Overall, the stimulus and responses emanating from clinical training should be aimed at improving the skills of clinical professionals. Health professions also need to show the regular use of theories and clear reasoning in educational activities, interactions with patients and clients, management, employee training, continuing education and health promotion programs, especially in the current health care structure.
For example, behaviorists underscore that learning should be a continuous process: the process should aim at achieving the needs that arise in the course of time. DeCoux (2016) observes that regular training of clinical workers is appropriate at all times as the latter reinforces positive behaviors. For instance, poor work relations and productivity among the clinical workers can be enhanced through training. The process also offers practical skills that are not normally taught in the classroom environment. Moreover, such a training program is created with great consideration of the specific needs and organizational interests. The trainers are given an opportunity to understand the needs of workers in a manner that influences the formulation of tactical human resource strategies.
In the same vein, clinical training is critical in talent development. The move allows administrators to assign duties according to the skills and qualifications of an individual. The process is helpful to enhance productivity and positive performance among the workers. Hessler & Henderson (2013) recognize that learning for nursing professionals should be interactive where their participation is paramount. Through this form of training, workers develop a better way to relate and connect with one another. It is also noteworthy that the clinical environment is changing by the day with new needs and dynamics that different approaches to offering to the right interventions. Therefore, clinical administrators need to promote continuous practical training among the staff.
Learni ...
This document provides an overview of health behavior theories and models. It discusses ecological models, individual-level theories like the Health Belief Model and Transtheoretical Model, and interpersonal theories including Social Cognitive Theory and social networks. Community and group models are also reviewed, along with using theory in research and practice through planning models. The document aims to describe the scope and foundations of health behavior as well as prominent theories across multiple levels.
This document provides an overview of health behavior theories and models. It discusses several key theories and models for understanding health behaviors at the individual, interpersonal, community, and group levels. These include the ecological model, health belief model, theory of reasoned action/planned behavior, transtheoretical model, social cognitive theory, social networks theory, and models of communication and media influences. The document also covers using these theories and models to design health behavior interventions and programs.
Rules for my assignments1. Kindly follow APA format (American Psy.docxkathyledlow2rr
The document provides instructions for an assignment on applying systems theory to address a problematic issue or process in a healthcare organization. Students are asked to:
1) Describe a problem in their organization.
2) Explain the problem from a closed-system perspective.
3) Describe how viewing the problem from an open-system perspective could help address it and improve healthcare outcomes.
4) Provide a conclusion.
The document also lists required readings on systems theory, organizational structures, and using systems-based practice to improve patient safety and care.
CHAPTER 10 MIXED METHODS PROCEDURESHow would you write a mixed mEstelaJeffery653
CHAPTER 10 MIXED METHODS PROCEDURES
How would you write a mixed methods procedure section for your proposal or study? Up until this point, we have considered collected quantitative data and qualitative data. We have not discussed “mixing” or combining the two forms of data in a study. We can start with the assumption that both forms of data provide different types of information (open-ended data in the case of qualitative and closed-ended data in the case of quantitative). If we further assume that each type of data collection has both limitations and strengths, we can consider how the strengths can be combined to develop a stronger understanding of the research problem or questions (and, as well, overcome the limitations of each). In a sense, more insight into a problem is to be gained from mixing or integration of the quantitative and qualitative data. This “mixing” or integrating of data, it can be argued, provides a stronger understanding of the problem or question than either by itself. Mixed methods research, therefore, is simply “mining” the databases more by integrating them. This idea is at the core of a new methodology called “mixed methods research.”
Conveying the nature of mixed methods research and its essential characteristics needs to begin a good mixed methods procedure. Start with the assumption that mixed methods is a methodology in research and that the readers need to be educated as to the basic intent and definition of the design, the reasons for choosing the procedure, and the value it will lend to a study. Then, decide on a mixed methods design to use. There are several from which to choose; consider the different possibilities and decide which one is best for your proposed study. With this choice in hand, discuss the data collection, the data analysis, and the data interpretation, discussion, and validation procedures within the context of the design. Finally, end with a discussion of potential ethical issues that need to be anticipated in the study, and suggest an outline for writing the final study. These are all standard methods procedures, and they are framed in this chapter as they apply to mixed methods research. Table 10.1 shows a checklist of the mixed methods procedures addressed in this chapter.
COMPONENTS OF MIXED METHODS PROCEDURES
Mixed methods research has evolved into a set of procedures that proposal developers and study designers can use in planning a mixed methods study. In 2003, the Handbook of Mixed Methods in the Social and Behavior Sciences (Tashakkori & Teddlie, 2003) was published (and later added to in a second edition, see Tashakkori & Teddlie, 2010), providing a comprehensive overview of this approach. Now several journals emphasize mixed methods research, such as the Journal of Mixed Methods Research, Quality and Quantity, Field Methods, and the International Journal of Multiple Research Approaches. Additional journals actively encourage this form of inquiry (e.g., International Journal of ...
PUH 5304, Health Behavior 1 Course Learning OutcomVannaJoy20
PUH 5304, Health Behavior 1
Course Learning Outcomes for Unit VI
Upon completion of this unit, students should be able to:
5. Examine health behavior intervention strategies.
5.1 Assess the many aspects that accompany intervention planning such as goals and objectives,
setting, community resources, and timelines.
5.2 Identify an intervention strategy that relates to intervention implementation within a community.
Course/Unit
Learning Outcomes
Learning Activity
5.1
Unit Lesson
Chapter 12
Unit VI Assignment
5.2
Unit Lesson
Chapter 12
Unit VI Assignment
Reading Assignment
Chapter 12: Translating Research to Practice: Putting “What Works” to Work
Unit Lesson
In Unit V, we addressed how theories and models such as the social cognitive theory, the health behavior
model, and the theory of planned behavior play a role in intervention planning. This unit, we will build on the
foundation of theories and models and look at how to be strategic in determining interventions. The reading
highlights the concerns that health educators should have as it relates to the design and evaluation process to
determine the successfulness of interventions for a given health behavior.
Intervention Strategizing
When a health educator is developing an intervention strategy to help with a particular health behavior, there
are a few key factors to consider: identifying the target population, selecting a setting, setting goals and
objectives, and identifying resources and a timeline. Each of these factors are a concern for health educators
when developing interventions (Powell et al., 2017).
Target population: Who are you planning the intervention for? Are there any special needs? For instance,
adolescents have special needs because they are in school during the day, so an intervention for them would
need to be after school, on the weekend, or through the school. An intervention for seniors should be held
during the day because seniors normally shy away from being out at dusk or dark. If the intervention were for
the working population, there would be better attendance in the evenings or weekends. The goal with
determining the population for the intervention is to think of alleviating any barriers that may affect most of the
population (Powell et al., 2017).
Setting: Where will the intervention be held? Is there handicap access for seniors or elevator accessibility? Is
the location easily accessible? Is there public parking? What is the room reservation process? Is the setting
outdoors, and if so, are there backup plans in case of bad weather? As the health educator, you should take
into account the best setting to meet the needs of the population that has been identified (Nilsen, 2015).
UNIT VI STUDY GUIDE
Interventions for Health Behavior
PUH 5304, Health Behavior 2
UNIT x STUDY GUIDE
Title
Goals/Objectives: The health educator should be clear on the goals and objectives of ...
This document summarizes the ECOTECH project which aims to understand how to better engage older adults in regional health innovation ecosystems in Canada. The project has three phases: 1) a scoping review of literature on regional innovation ecosystems and end-user engagement; 2) interviews with stakeholders and focus groups with older adults to understand current practices and opportunities for participation; 3) an ongoing concept mapping approach using mixed methods to further explore how partnerships can evolve to support appropriate health innovations for older adults. Preliminary findings indicate that while regional health innovation ecosystems could benefit from older adult engagement, there are currently limited roles for communities and barriers like ageism that need to be addressed.
A Comparison of Key Models in Health InformaticsAs part of this co.docxJospehStull43
A Comparison of Key Models in Health Informatics
As part of this course, you will be developing an evaluation plan based on an appropriate model. For this Assignment, you will examine in depth the four models introduced in this week's Learning Resources (
Technology Acceptance, Model Diffusion of Innovations, Disruptive Innovation, Sociotechnical Theory Models
).
By increasing your familiarity with these key models, you will more easily recognize which would be most appropriate for the evaluation you decide to perform.
To prepare:
Review the four research models covered in this week’s Learning Resources.
Consider the key points of each and when they would be the most appropriate choice for an evaluation.
To complete
this Assignment:
By Thursday 12/22/2016 by 5pm,
1)
Create graphic representations of the four models, including descriptions of each overall model, key components, who was involved in their development, key ways they have been used, and potential uses in health informatics.
2)
These representations will be for your use in your upcoming course project, so the greater the detail, the more useful these representations will be to you.
3)
Potential formats could include but are not limited to tables, mind maps, Venn diagrams, or concept maps.
P.S. include an introduction and a summary. The introduction must end with a purpose statement (e.g. “The purpose of this paper is to …” ) in APA format.
Use the references listed in the instructions area for this assignment.
Thank you!
Required Readings
Technology Acceptance Model
Kowitlawakul, Y. (2011). The Technology Acceptance Model: Predicting nurses’ intention to use telemedicine technology (eICU). Computers, Informatics, Nursing, 29(7), 411–418.
Retrieved from the Walden Library databases.
Nurses encounter a variety of technological tools that are used in their field. This article explores the technology acceptance model and how it applies to nurses’ intention to use telemedicine technology.
Pai, F.-Y., & Huang, K. (2011). Applying the Technology Acceptance Model to the introduction of healthcare information systems. Technological Forecasting and Social Change, 78(4), 650–660.
Retrieved from the Walden Library databases.
This article focuses on the attempt to develop a model that will assist nurses in mastering the use of health information technology (HIT), thus enabling them to spend more time on patient care and less on clerical-type duties. The authors also studied how the use of HIT could increase patient safety.
Rippen, H. E., Pan, E. C., Russell, C., Byrne, C. M., & Swift, E. K. (2013). Organizational framework for health information technology. International Journal of Medical Informatics, 82(4), e1–e13.
Retrieved from the Walden Library databases.
In this article, the authors highlight results of a literature review on the implementation of health information technology and the related theories and models. Based on their research, the authors developed a fra.
Name olubunmi salako date 1262021identification of scenariojack60216
This document provides an annotated bibliography by Olubunmi Salako for a leadership and management in nursing course. It summarizes four sources that discuss various aspects of patient education, nursing standards, and healthcare policy. The sources examine how competency-based nursing curriculum and educational interventions can improve compliance with nursing standards. They also discuss how health policies and addressing social determinants can help reduce public health problems and disparities. The annotations provide details on the authors and relevance of each source to topics like patient education, nursing practice standards, and using policy to influence health outcomes.
1) The document discusses agenda setting in the policy process and how clinical practice issues can be moved onto organizational agendas. It provides required readings on stakeholder engagement, policy briefs, and examples of nursing advocacy in policymaking.
2) Students are asked to identify a clinical practice issue for their organization's agenda and propose strategies to inform and persuade stakeholders of its importance using insights from the provided media presentation and readings.
1) The document discusses agenda setting in the policy process and how clinical practice issues can be moved onto organizational agendas.
2) It provides required readings on stakeholder engagement, policy briefs, nursing advocacy, and research usefulness for policymaking.
3) Readers are asked to identify a clinical practice issue for their organization's agenda, stakeholders interested in the issue, and strategies to inform and persuade stakeholders of the issue's importance.
This document provides guidance for nurses on developing a policy brief to advocate for one of the recommendations from the Institute of Medicine's 2010 report "The Future of Nursing: Leading Change, Advancing Health." It outlines the components that should be included in a 2-3 page single-spaced policy brief, such as a short introduction stating the problem, the selected recommendation, background on the issue, current solutions and status, and a conclusion. Nurses are encouraged to write policy briefs to communicate health policy issues clearly to decision makers and advocate for changes that can improve health outcomes.
Please read the description of the Religion ethnography carefully an.docxSusanaFurman449
Please read the description of the Religion ethnography carefully and then ask me in class to explain anything that isn't clear. You can also email me with questions.
At the end there is a short list of possible sites for the ethnography: Sikh, Islamic, Jewish, Catholic, Hindu, Buddhist. Shumei. There are other religions and many other sites. Bahai is an interesting religion but you have to be invited to attend by a member.
Mormon the same.
If you have access to a Santeria or similar ceremony, great!
To make the project worthwhile choose a site as different from your own background as you can.
If you have a Christian or Catholic background do not do your paper on any kind of Christian or Catholic service.
You are welcome to attend a non-English language service as long as you understand the language being used.
Be sure to okay your choice with me. Some places that don’t work for this project are Scientology, the Self Realization Fellowship, the Kabbalah Center, SGI Buddhist, Hare Krishna.
INSTRUCTIONS:
Attend a religious activity that you’re curious about and would like to explore.
You must attend a service, not simply visit a religious site.
Examples: a mosque, temple, synagogue, gurdwara.
You can probably find an interesting place of worship near where you live or work.
It’s always a good idea to phone or email the place of worship before you attend.
Research methods must include participant/observation and informal conversation. One slightly more formal interview is desirable.
Be absolutely sure to allow time to stay after the service for food, lunch, other refreshment, or informal gathering. This may well be the most important part of your experience and will enable you to answer the question, “What meaning does this place and this service have for the participants?
You must go some place you’ve never been to before. Do NOT choose your own tradition or somewhere you’re even a bit familiar with. Choose somewhere entirely new and different.
The important thing is to come to the service as an outsider, with the eyes and ears of an anthropologist and take note of everything. Use the skills you’ve learned in this class.
You can attend alone or with a co-researcher or two from the class. Best, you can be the guest(s) of a classmate or someone else you know and discuss the event with them. Invite a classmate or two to attend a service from your tradition.
Do not write about an event you attended in the past. But you can use past experiences for comparison and reflection.
It is almost never appropriate to jot down notes during a religious service. Better, write everything you remember immediately after the event. Get sufficient detail to write what anthropologist Clifford Geertz called “thick”, or rich description.
In writing your paper use terms we've discussed in class and think about connections to the reading we’ve done and films we’ve seen.
OUTLINE
: Include each of these sections.
Title Page,
or top of page: .
PLEASE read the question carefully. The creation of teen ido.docxSusanaFurman449
PLEASE read the question carefully.
The creation of “teen idols” is a tradition that stems back to Tin Pan Alley and the “old guard” way of making music. What were some of the factors that led to this point in the early 60’s? Is it still prevalent? If so, why? Name some examples.
.
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This document provides an introduction and table of contents for a resource guide on implementation science. The guide aims to help decision makers and practitioners apply implementation science concepts to more effectively deliver evidence-based practices. The introduction defines implementation science as a way to close the gap between innovation and real-world practice. The table of contents previews sections on whether implementation is a science, common implementation models and frameworks, relevant research methods, and examples of applying implementation science in real-world settings. The resource guide is intended to connect readers with implementation science and facilitate more effective long-term use of specific evidence-based practices.
Don de Savigny: Systems Thinking Methodologies for Health Systems Research – ...Rebekah McKay-Smith
This document provides an introduction to systems thinking methodologies for health systems research. It discusses:
1) The need to consider the complexity of health systems rather than view them as simple linear models.
2) An overview of key concepts in systems thinking like complex adaptive systems, feedback loops, and leverage points for intervention.
3) Examples of applying systems thinking approaches to health systems research like network analysis, system dynamics modeling, and process mapping.
Looking at implementation: how useful is realist evaluation?valéry ridde
Presentation by Emilie Robert (McGill University).
Global Health Workshop: Methods For Implementation Science in Global Health.
http://www.equitesante.org/implementation-science-methods-in-global-health/
This document outlines the requirements for a scholar-practitioner project on public health leadership theory. It includes sections on an abstract and introduction, literature review and problem statement, personal leadership theory, visual representation of the theory, and an empirical evaluation plan. The literature review must synthesize 15-20 peer-reviewed sources and identify theoretical gaps. The problem statement must address the gaps and implications for social change. The personal leadership theory and visual representation must address the identified gaps. The evaluation plan must suggest how to assess if the new theory addresses the identified problem.
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I need between 100-120 words for each assignment, and I want individual references with each response. Please, no plagiarized work
Module 1
DQ 1
Outcome measures are significant in showing the worth of the Doctor of Nursing Practice's role in health care. Identify a practice-level outcome study or project and describe the expectation of its effect on health care. Which outcome measure do you think aligns with your DPI project (Quality Improvement Project)? Why? Provide examples and literature support.
DQ 2
In this week's readings, theories of accident causation, human error, foresight, resilience, and system migration were discussed. Identify a safety theory and propose quality measures to improve patient safety. Which theory or framework are you using to guide your DPI Project's intervention and outcome? Please define what constructs of your chosen DPI Project theory will help you change/improve clinical practice to improve a specific patient outcome? Provide examples and literature support.
Resources
Henneman, E. A. (2017). Recognizing the ordinary as extraordinary: Insight into the “way we work” to improve patient safety outcomes.
American Journal of Critical Care
,
26
(4), 272–277. doi:10.4037/ajcc2017812
Smith, S. A., Yount, N., & Sorra, J. (2017). Exploring relationships between hospital patient safety culture and Consumer Reports safety scores.
BMC Health Services Research
,
17,
1-9. doi:10.1186/s12913-017-2078-6
Module 2
DQ 1
Discuss economic methodology, including the concept of cost-based analysis. If you will not be addressing this in your DPI Project, provide an example of a program where it could be used to show outcomes. Provide examples and literature support.
DQ 2
Discuss a change theory and how it can be or has been applied in nursing practice to integrate care delivery sustainability. How will you use change theory in the design of your project to support the sustainability of your practice improvement intervention? Provide examples and literature support.
Resources
Uluskan, M., McCreery, J. K., & Rothenberg, L. (2018). Impact of quality management practices on change readiness due to new quality implementations.
International Journal of Lean Six Sigma
,
9
(3), 351-373. doi:10.1108/IJLSS-05-2017-0049
Steele Gray, C., Wilkinson, A., Alvaro, C., Wilkinson, K., & Harvey, M. (2015). Building resilience and organizational readiness during healthcare facility redevelopment transitions: Is it possible to thrive?
HERD: Health Environments Research & Design Journal
,
9
(1), 10-33. doi:10.1177/1937586715593552
Allen, B. (2016). Effective design, implementation and management of change in healthcare.
Nursing Standard
,
31
(3), 58. doi:10.7748/ns.2016.e10375
Module 3
DQ 1
New health care delivery models are being presented to accommodate the shift in health care objectives. Many of these models are community-based and focused on improving quality outcomes, population health, and reducing readmissions.
Reflective Journal Week 5Topic Philosophies and Theories for Ad.docxsodhi3
Reflective Journal Week 5
Topic: Philosophies and Theories for Advanced Nursing Practice
Course objective:
1. Examine disciplinary influences on nursing inquiry such as biology, medicine, psychology, sociology, and philosophy, among others.
2. Evaluate the application and adaptation of borrowed theories to nursing practice.
Discussion Question: 5 DQ 1
Learning theories have implications for advanced practice nurses outside the classroom. Share an example describing the application of learning theory or theories to develop a program targeting change to a specific organizational issue, patient lifestyle, or specific unhealthy behaviors.
Nursing education is essential to equip professionals with appropriate skills and competencies in line with the changing demands. In this regard, learning theories offer important guidelines for planning of an educational system within the clinical training. Two important areas highlighted in any theory include a change of behavior and talent development. Overall, the stimulus and responses emanating from clinical training should be aimed at improving the skills of clinical professionals. Health professions also need to show the regular use of theories and clear reasoning in educational activities, interactions with patients and clients, management, employee training, continuing education and health promotion programs, especially in the current health care structure.
For example, behaviorists underscore that learning should be a continuous process: the process should aim at achieving the needs that arise in the course of time. DeCoux (2016) observes that regular training of clinical workers is appropriate at all times as the latter reinforces positive behaviors. For instance, poor work relations and productivity among the clinical workers can be enhanced through training. The process also offers practical skills that are not normally taught in the classroom environment. Moreover, such a training program is created with great consideration of the specific needs and organizational interests. The trainers are given an opportunity to understand the needs of workers in a manner that influences the formulation of tactical human resource strategies.
In the same vein, clinical training is critical in talent development. The move allows administrators to assign duties according to the skills and qualifications of an individual. The process is helpful to enhance productivity and positive performance among the workers. Hessler & Henderson (2013) recognize that learning for nursing professionals should be interactive where their participation is paramount. Through this form of training, workers develop a better way to relate and connect with one another. It is also noteworthy that the clinical environment is changing by the day with new needs and dynamics that different approaches to offering to the right interventions. Therefore, clinical administrators need to promote continuous practical training among the staff.
Learni ...
This document provides an overview of health behavior theories and models. It discusses ecological models, individual-level theories like the Health Belief Model and Transtheoretical Model, and interpersonal theories including Social Cognitive Theory and social networks. Community and group models are also reviewed, along with using theory in research and practice through planning models. The document aims to describe the scope and foundations of health behavior as well as prominent theories across multiple levels.
This document provides an overview of health behavior theories and models. It discusses several key theories and models for understanding health behaviors at the individual, interpersonal, community, and group levels. These include the ecological model, health belief model, theory of reasoned action/planned behavior, transtheoretical model, social cognitive theory, social networks theory, and models of communication and media influences. The document also covers using these theories and models to design health behavior interventions and programs.
Rules for my assignments1. Kindly follow APA format (American Psy.docxkathyledlow2rr
The document provides instructions for an assignment on applying systems theory to address a problematic issue or process in a healthcare organization. Students are asked to:
1) Describe a problem in their organization.
2) Explain the problem from a closed-system perspective.
3) Describe how viewing the problem from an open-system perspective could help address it and improve healthcare outcomes.
4) Provide a conclusion.
The document also lists required readings on systems theory, organizational structures, and using systems-based practice to improve patient safety and care.
CHAPTER 10 MIXED METHODS PROCEDURESHow would you write a mixed mEstelaJeffery653
CHAPTER 10 MIXED METHODS PROCEDURES
How would you write a mixed methods procedure section for your proposal or study? Up until this point, we have considered collected quantitative data and qualitative data. We have not discussed “mixing” or combining the two forms of data in a study. We can start with the assumption that both forms of data provide different types of information (open-ended data in the case of qualitative and closed-ended data in the case of quantitative). If we further assume that each type of data collection has both limitations and strengths, we can consider how the strengths can be combined to develop a stronger understanding of the research problem or questions (and, as well, overcome the limitations of each). In a sense, more insight into a problem is to be gained from mixing or integration of the quantitative and qualitative data. This “mixing” or integrating of data, it can be argued, provides a stronger understanding of the problem or question than either by itself. Mixed methods research, therefore, is simply “mining” the databases more by integrating them. This idea is at the core of a new methodology called “mixed methods research.”
Conveying the nature of mixed methods research and its essential characteristics needs to begin a good mixed methods procedure. Start with the assumption that mixed methods is a methodology in research and that the readers need to be educated as to the basic intent and definition of the design, the reasons for choosing the procedure, and the value it will lend to a study. Then, decide on a mixed methods design to use. There are several from which to choose; consider the different possibilities and decide which one is best for your proposed study. With this choice in hand, discuss the data collection, the data analysis, and the data interpretation, discussion, and validation procedures within the context of the design. Finally, end with a discussion of potential ethical issues that need to be anticipated in the study, and suggest an outline for writing the final study. These are all standard methods procedures, and they are framed in this chapter as they apply to mixed methods research. Table 10.1 shows a checklist of the mixed methods procedures addressed in this chapter.
COMPONENTS OF MIXED METHODS PROCEDURES
Mixed methods research has evolved into a set of procedures that proposal developers and study designers can use in planning a mixed methods study. In 2003, the Handbook of Mixed Methods in the Social and Behavior Sciences (Tashakkori & Teddlie, 2003) was published (and later added to in a second edition, see Tashakkori & Teddlie, 2010), providing a comprehensive overview of this approach. Now several journals emphasize mixed methods research, such as the Journal of Mixed Methods Research, Quality and Quantity, Field Methods, and the International Journal of Multiple Research Approaches. Additional journals actively encourage this form of inquiry (e.g., International Journal of ...
PUH 5304, Health Behavior 1 Course Learning OutcomVannaJoy20
PUH 5304, Health Behavior 1
Course Learning Outcomes for Unit VI
Upon completion of this unit, students should be able to:
5. Examine health behavior intervention strategies.
5.1 Assess the many aspects that accompany intervention planning such as goals and objectives,
setting, community resources, and timelines.
5.2 Identify an intervention strategy that relates to intervention implementation within a community.
Course/Unit
Learning Outcomes
Learning Activity
5.1
Unit Lesson
Chapter 12
Unit VI Assignment
5.2
Unit Lesson
Chapter 12
Unit VI Assignment
Reading Assignment
Chapter 12: Translating Research to Practice: Putting “What Works” to Work
Unit Lesson
In Unit V, we addressed how theories and models such as the social cognitive theory, the health behavior
model, and the theory of planned behavior play a role in intervention planning. This unit, we will build on the
foundation of theories and models and look at how to be strategic in determining interventions. The reading
highlights the concerns that health educators should have as it relates to the design and evaluation process to
determine the successfulness of interventions for a given health behavior.
Intervention Strategizing
When a health educator is developing an intervention strategy to help with a particular health behavior, there
are a few key factors to consider: identifying the target population, selecting a setting, setting goals and
objectives, and identifying resources and a timeline. Each of these factors are a concern for health educators
when developing interventions (Powell et al., 2017).
Target population: Who are you planning the intervention for? Are there any special needs? For instance,
adolescents have special needs because they are in school during the day, so an intervention for them would
need to be after school, on the weekend, or through the school. An intervention for seniors should be held
during the day because seniors normally shy away from being out at dusk or dark. If the intervention were for
the working population, there would be better attendance in the evenings or weekends. The goal with
determining the population for the intervention is to think of alleviating any barriers that may affect most of the
population (Powell et al., 2017).
Setting: Where will the intervention be held? Is there handicap access for seniors or elevator accessibility? Is
the location easily accessible? Is there public parking? What is the room reservation process? Is the setting
outdoors, and if so, are there backup plans in case of bad weather? As the health educator, you should take
into account the best setting to meet the needs of the population that has been identified (Nilsen, 2015).
UNIT VI STUDY GUIDE
Interventions for Health Behavior
PUH 5304, Health Behavior 2
UNIT x STUDY GUIDE
Title
Goals/Objectives: The health educator should be clear on the goals and objectives of ...
This document summarizes the ECOTECH project which aims to understand how to better engage older adults in regional health innovation ecosystems in Canada. The project has three phases: 1) a scoping review of literature on regional innovation ecosystems and end-user engagement; 2) interviews with stakeholders and focus groups with older adults to understand current practices and opportunities for participation; 3) an ongoing concept mapping approach using mixed methods to further explore how partnerships can evolve to support appropriate health innovations for older adults. Preliminary findings indicate that while regional health innovation ecosystems could benefit from older adult engagement, there are currently limited roles for communities and barriers like ageism that need to be addressed.
A Comparison of Key Models in Health InformaticsAs part of this co.docxJospehStull43
A Comparison of Key Models in Health Informatics
As part of this course, you will be developing an evaluation plan based on an appropriate model. For this Assignment, you will examine in depth the four models introduced in this week's Learning Resources (
Technology Acceptance, Model Diffusion of Innovations, Disruptive Innovation, Sociotechnical Theory Models
).
By increasing your familiarity with these key models, you will more easily recognize which would be most appropriate for the evaluation you decide to perform.
To prepare:
Review the four research models covered in this week’s Learning Resources.
Consider the key points of each and when they would be the most appropriate choice for an evaluation.
To complete
this Assignment:
By Thursday 12/22/2016 by 5pm,
1)
Create graphic representations of the four models, including descriptions of each overall model, key components, who was involved in their development, key ways they have been used, and potential uses in health informatics.
2)
These representations will be for your use in your upcoming course project, so the greater the detail, the more useful these representations will be to you.
3)
Potential formats could include but are not limited to tables, mind maps, Venn diagrams, or concept maps.
P.S. include an introduction and a summary. The introduction must end with a purpose statement (e.g. “The purpose of this paper is to …” ) in APA format.
Use the references listed in the instructions area for this assignment.
Thank you!
Required Readings
Technology Acceptance Model
Kowitlawakul, Y. (2011). The Technology Acceptance Model: Predicting nurses’ intention to use telemedicine technology (eICU). Computers, Informatics, Nursing, 29(7), 411–418.
Retrieved from the Walden Library databases.
Nurses encounter a variety of technological tools that are used in their field. This article explores the technology acceptance model and how it applies to nurses’ intention to use telemedicine technology.
Pai, F.-Y., & Huang, K. (2011). Applying the Technology Acceptance Model to the introduction of healthcare information systems. Technological Forecasting and Social Change, 78(4), 650–660.
Retrieved from the Walden Library databases.
This article focuses on the attempt to develop a model that will assist nurses in mastering the use of health information technology (HIT), thus enabling them to spend more time on patient care and less on clerical-type duties. The authors also studied how the use of HIT could increase patient safety.
Rippen, H. E., Pan, E. C., Russell, C., Byrne, C. M., & Swift, E. K. (2013). Organizational framework for health information technology. International Journal of Medical Informatics, 82(4), e1–e13.
Retrieved from the Walden Library databases.
In this article, the authors highlight results of a literature review on the implementation of health information technology and the related theories and models. Based on their research, the authors developed a fra.
Name olubunmi salako date 1262021identification of scenariojack60216
This document provides an annotated bibliography by Olubunmi Salako for a leadership and management in nursing course. It summarizes four sources that discuss various aspects of patient education, nursing standards, and healthcare policy. The sources examine how competency-based nursing curriculum and educational interventions can improve compliance with nursing standards. They also discuss how health policies and addressing social determinants can help reduce public health problems and disparities. The annotations provide details on the authors and relevance of each source to topics like patient education, nursing practice standards, and using policy to influence health outcomes.
1) The document discusses agenda setting in the policy process and how clinical practice issues can be moved onto organizational agendas. It provides required readings on stakeholder engagement, policy briefs, and examples of nursing advocacy in policymaking.
2) Students are asked to identify a clinical practice issue for their organization's agenda and propose strategies to inform and persuade stakeholders of its importance using insights from the provided media presentation and readings.
1) The document discusses agenda setting in the policy process and how clinical practice issues can be moved onto organizational agendas.
2) It provides required readings on stakeholder engagement, policy briefs, nursing advocacy, and research usefulness for policymaking.
3) Readers are asked to identify a clinical practice issue for their organization's agenda, stakeholders interested in the issue, and strategies to inform and persuade stakeholders of the issue's importance.
This document provides guidance for nurses on developing a policy brief to advocate for one of the recommendations from the Institute of Medicine's 2010 report "The Future of Nursing: Leading Change, Advancing Health." It outlines the components that should be included in a 2-3 page single-spaced policy brief, such as a short introduction stating the problem, the selected recommendation, background on the issue, current solutions and status, and a conclusion. Nurses are encouraged to write policy briefs to communicate health policy issues clearly to decision makers and advocate for changes that can improve health outcomes.
Similar to Here is a research tip We write the theory into a separate sectio (20)
Please read the description of the Religion ethnography carefully an.docxSusanaFurman449
Please read the description of the Religion ethnography carefully and then ask me in class to explain anything that isn't clear. You can also email me with questions.
At the end there is a short list of possible sites for the ethnography: Sikh, Islamic, Jewish, Catholic, Hindu, Buddhist. Shumei. There are other religions and many other sites. Bahai is an interesting religion but you have to be invited to attend by a member.
Mormon the same.
If you have access to a Santeria or similar ceremony, great!
To make the project worthwhile choose a site as different from your own background as you can.
If you have a Christian or Catholic background do not do your paper on any kind of Christian or Catholic service.
You are welcome to attend a non-English language service as long as you understand the language being used.
Be sure to okay your choice with me. Some places that don’t work for this project are Scientology, the Self Realization Fellowship, the Kabbalah Center, SGI Buddhist, Hare Krishna.
INSTRUCTIONS:
Attend a religious activity that you’re curious about and would like to explore.
You must attend a service, not simply visit a religious site.
Examples: a mosque, temple, synagogue, gurdwara.
You can probably find an interesting place of worship near where you live or work.
It’s always a good idea to phone or email the place of worship before you attend.
Research methods must include participant/observation and informal conversation. One slightly more formal interview is desirable.
Be absolutely sure to allow time to stay after the service for food, lunch, other refreshment, or informal gathering. This may well be the most important part of your experience and will enable you to answer the question, “What meaning does this place and this service have for the participants?
You must go some place you’ve never been to before. Do NOT choose your own tradition or somewhere you’re even a bit familiar with. Choose somewhere entirely new and different.
The important thing is to come to the service as an outsider, with the eyes and ears of an anthropologist and take note of everything. Use the skills you’ve learned in this class.
You can attend alone or with a co-researcher or two from the class. Best, you can be the guest(s) of a classmate or someone else you know and discuss the event with them. Invite a classmate or two to attend a service from your tradition.
Do not write about an event you attended in the past. But you can use past experiences for comparison and reflection.
It is almost never appropriate to jot down notes during a religious service. Better, write everything you remember immediately after the event. Get sufficient detail to write what anthropologist Clifford Geertz called “thick”, or rich description.
In writing your paper use terms we've discussed in class and think about connections to the reading we’ve done and films we’ve seen.
OUTLINE
: Include each of these sections.
Title Page,
or top of page: .
PLEASE read the question carefully. The creation of teen ido.docxSusanaFurman449
PLEASE read the question carefully.
The creation of “teen idols” is a tradition that stems back to Tin Pan Alley and the “old guard” way of making music. What were some of the factors that led to this point in the early 60’s? Is it still prevalent? If so, why? Name some examples.
.
Please reflect on the relationship between faith, personal disciplin.docxSusanaFurman449
Please reflect on the relationship between faith, personal discipline, and political integrity. Explain how the Progressive movement and the New Deal Court transformed constitutional interpretation. Briefly give 2 illustrations of how government regulations and/or subsidies (legal plunder, perhaps?) channels behavior and/or distorts markets. 400 WORDS
.
Please read the following questions and answer the questions.docxSusanaFurman449
Please read the following questions and answer the questions
This unit's chapter discussed concerns about quality programming in the media. Different models for assessing culture were discussed:
1) Culture as a Skyscraper Model and 2) Culture as a Map.
Come up with several television shows that serve as examples of “quality” programs and “trashy” programs. What characteristics determine their quality (plots, subject matter, themes, characters…)?
Is there anything you can think of that is “universally trashy”? Or universally in good taste?
On the whole, are Americans seen as having good taste? Why or why not? Is there a country/culture that always seems tasteful in its cultural products?
Which model (Culture as Skyscraper or Culture as Map) makes more sense to you and why?
i need 400 words
.
PRAISE FOR CRUCIAL CONVERSATIONS Relationships ar.docxSusanaFurman449
PRAISE FOR CRUCIAL CONVERSATIONS
"Relationships are the priority of life, and conversations are the
crucial element in profound caring of relationships. This book
helps us to think about what we really want to say. If you want
to succeed in both talking and listening, read this book."
-Dr. Lloyd J. Ogilvie, chaplain, United States Senate
"Important, lucid, and practical, Crucial Conversations is a
book that will make a difference in your life. Learn how to flour
ish in every difficult situation."
-Robert E. Quinn, ME Tracy Collegiate Professor of
OBHRM, University of Michigan Business School
"I was personally and professionally inspired by this book-and
I'm not easily impressed. In the fast-paced world of IT, the success
of our systems, and our business, depends on crucial conversations
we have every day. Unfortunately, because our environment is so
technical, far too often we forget about the 'human systems' that
make or break us. These skills are the missing foundation piece."
-Maureen Burke, manager of training,
Coca-Cola Enterprises, Inc.
"The book is compelling. Yes, I found myself in too many of their
examples of what not to do when caught in these worst-of-all
worlds situations! GET THIS BOOK, WHIP OUT A PEN AND
GET READY TO SCRIBBLE MARGIN NOTES FURIOUSLY,
AND PRACTICE, PRACTICE, PRACTICE THE INVALUABLE
TOOLS THESE AUTHORS PRESENT. I know I did-and it
helped me salvage several difficult situations and repair my
damaged self-esteem in others. I will need another copy pretty
soon. as I'm wearing out the pages in this one!"
-James Belasco. best-selling author of Flight of the Buffalo,
l!l1trl!prl!l1eur. professor. und l!xl!cutive director of the Financial
Tilllrs Knowkdgc Diuloguc
"Crucial Conversations is the most useful self-help book I have
ever read. I'm awed by how insightful, readable, well organized,
and focused it is. I keep thinking: 'If only I had been exposed to
these dialogue skills 30 years ago ... '"
-John Hatch, founder, FINCA International
"One of the greatest tragedies is seeing someone with incredible
talent get derailed because he or she lacks some basic skills.
Crucial Conversations addresses the number one reason execu
tives derail, and it provides extremely helpful tools to operate in
a fast-paced, results-oriented environment."
-Karie A. Willyerd, chief talent officer, Solectron
"The book prescribes, with structure and wit, a way to improve on
the most fundamental element of organizational learning and
growth-honest, unencumbered dialogue between individuals.
There are one or two of the many leadership/management
'thought' books on my shelf that are frayed and dog-eared from
use. Crucial Conversations will no doubt end up in the same con
dition."
-John Gill, VP of Human Resources, Rolls Royce USA
Crucial
Conversations
Crucial
Conversations
Tools for Talking
When Stakes Are High
by
Kerry Patterson, .
Must Be a
hip-hop concert!!!!
attend a
hip-hop concert (in-person or virtual/recorded live concert on DVD or streaming platform) of your choice
THIS month.
After the concert, write an
objective review (1000 - 1500 words) of the concert detailing your experience.
Write A Review and include those questions!!!
The review should include:
1. The names of the performing groups/artists; the date and location of the performance.
2. Describe the setting. Is it a large hall or an intimate theater? What type of audience demographic is there? Young or old? How do they respond to the music?
3. The different styles/genres of songs the artist(s) perform.
4. Use your notes and experience to describe the different musical elements (i.e. melody, harmony, timbre, technology, form, volume, etc.) you recognize in most (if not all) the songs/pieces.
5. Be sure to arrive on time to hear the
entire concert.
6. Attach a photo of the flyer, ticket, or webpage (or social media event) when you submit this assignment.
7. Describe your personal reaction to the concert. List reasons why you think it was successful or not. However, do not make this the center of your paper. It should be
one or two paragraphs at the end. Further, use
data to support your arguments about why it was successful or not successful. (e.g., How did people respond verbally and non-verbally? Was this based on your perception or was there a general consensus? If it is a consensus, then what facts do you have to support this?)
8. Try to do some background research on the genre or artist before and after you attend the concert. This is not a research paper, but if you use any information from any source (including the artist's website), you
must cite it both in-text and on a works-cited page.
.
Mini-Paper #3 Johnson & Johnson and a Tale of Two Crises - An Eth.docxSusanaFurman449
Mini-Paper #3: Johnson & Johnson and a Tale of Two Crises - An Ethics Story Revised Submission
Read the following two PDF documents located at this link: click hereLinks to an external site.
·
Johnson & Johnson’s Tylenol Crisis
·
JNJ’s Baby Powder Crisis: Does Baby Powder Cause Cancer?
·
You are not expected to conduct any outside research
Based on your reading please write a short paper answering the following questions (do not answer with bullets, write a paper):
· JNJ’s response to the Tylenol Crisis is often cited as one of the best historical crisis management leadership examples. Given this perspective:
·
Compare JNJ’s response to the Tylenol Crisis to their response in the Baby Powder Crisis.
·
What actions by JNJ were highly effective in the Tylenol Crisis and why? Explain your examples and why you believe they are best practices
·
What could JNJ improve upon in the Tylenol Crisis?
· After reading JNJ's handling of the Baby Powder Class Action Lawsuit elaborate upon the following:
·
How did JNJs response differ from the Tylenol Crisis in the Baby Powder Lawsuit?
·
Given what you've learned from the Tylenol Crisis what are three potential recommendations/improvements JNJ could have made in the Baby Powder Lawsuit?
·
Ethics Analysis - consider your decision from the perspective of a senior advisor to senior leadership at JNJ (
there is NO right answer here, YOU MAY GIVE OPINION IN FIRST PERSON IN THIS SECTION ONLY (this is a special exception)):
·
· With what ethical actions do you agree or disagree regarding how JNJ handled the Tylenol Crisis?
· With what ethical actions do you agree or disagree regarding how JNJ handled the Baby Powder Crisis?
·
Be sure to reference at least 3 concepts from Chapters 9 and/or 12 in the textbook in answering this mini-paper. Please mark your references with "(textbook)" to make clear the references from the book.
Johnson & Johnson’s Tylenol Crisis
Background
“The killer’s motives remain unknown, but his — or her, or their — technical
savvy is as chilling today as it was 30 years ago.
On Sept. 29, 1982, three people died in the Chicago area after taking
cyanide-laced Tylenol at the outset of a poisoning spree that would claim seven
lives by Oct. 1. The case has never been solved, and so the lingering question —
why? — still haunts investigators.
Food and Drug Administration officials hypothesized that the killer bought
Extra-Strength Tylenol capsules over the counter, injected cyanide into the red
half of the capsules, resealed the bottles, and sneaked them back onto the shelves
of drug and grocery stores. The Illinois attorney general, on the other hand,
suspected a disgruntled employee on Tylenol’s factory line. In either case, it was a
sophisticated and ambitious undertaking with the seemingly pathological go.
Please write these 2 assignments in first person.docxSusanaFurman449
Please write these 2 assignments in
first person view. No need for citation. Please give me two files, the first one is a
Short Paper(600-700 words); the second one is
Long Discussion(450-500 words).
They are all about Art and Politics in Renaissance Florence Period
1. Short Paper
Street corners, guild halls, government offices, and confraternity centers contained works of art that made the city of Florence a visual jewel at precisely the time of its emergence as a European cultural leader. In shared religious and secular spaces, people from the city of Florence commissioned altarpieces, chapels, buildings, textiles, all manner of objects – at home, interior spaces were animated with smaller-scale works, such as family portraits, birth trays, decorated pieces of furniture, all of which relied on patrons, artists, and audiences working with the beauty and power of sensory experience. Like people all over Europe, viewers believed in the power of images, and they shared an understanding of the persuasiveness of art and architecture. Florentines accepted the utterly vital role that art could play as a propagator of civic, corporate, religious, political and individual identity.
Select one or two of the test case studies [that is, talk about Cosimo or Lorenzo the Magnificent or Savonarola's impact on Florence or the new Republic under Soderini] from this Module on Art and Politics in Renaissance Florence, and explore your understanding of people in Florence, who was so alive to the power and communication possibilities in works of art, objects, and spaces throughout the city and beyond.
Word count:
600-700 words
No need for citations.
2. Long Discussion
In this longer discussion forum, create an initial post of
450-500 words that explores these key concepts;
In this discussion post, talk about the political and social messages that you can see in the various works of art commissioned by the Medici, all the while being aware of the debate that was circulating about power and religion. If the content of the work of art is religious, how does the work convey political messages?
a video that may help
https://www.youtube.com/watch?v=UAqE21zjQH4
.
Personal Leadership Training plan AttributesColumbia South.docxSusanaFurman449
Personal Leadership Training plan : Attributes
Columbia Southern University
Dr. Mark Friske
Current Issues in Leadership
LDR 6302-22.01.00
10/14/2022
Introduction
Personal leadership style
personal leadership style attributes
Characteristics of a democratic leader
Charismatic leadership style
Charismatic leader
Transformational leadership style
Transformational leader
Charismatic vs. transformational
Impacts of transformational leadership
Reflection
Personal leadership style
Democratic leadership style
Embraces diversity and open dialogue as core values.
The leader's role is to provide direction and exercise authority.
Commands respect and admiration from those who follow you.
Moral principles and personal beliefs underpin all choices.
Seek out a wide range of perspectives (Cherry, 2020).
Behaviorist theory is the one that fits my style of leadership the best.
Being the change you wish to see in the world is crucial, in my opinion. According to Johann Wolfgang von Goethe, "Behavior is the mirror in which everyone exhibits their picture." My main priorities are the well-being of the team members and developing effective solutions via cooperative effort.
personal leadership style attributes
Active participant
Each person is given a fair chance to speak their mind, and there is no pressure to conform to any one viewpoint.
Values other standpoints
I find it fascinating to hear the perspectives of others. To me, it's crucial that everyone in the team pitches in to find the most effective answer. To me, it's important to give everyone a voice on the team since they all have something unique to offer.
Characteristics of democratic leader
Attribute:
Talk About It
Subcontract Work
Get Other People's Opinions
Friendly
Approachable
Trustworthy
Participative
Motivate Originality
Regard for Others
Build Confidence
Life example
Working as a Management Analyst in the realm of government spending, I am frequently required to communicate with the Program Management Team of a third party firm. No collimated staff members prevent me from personally performing some of the work necessary to maintain an accurate external organization ledger. As a result, I need to be approachable, polite, and nice to my coworkers so that they would feel comfortable confiding in me and trusting me with their ideas. By consistently soliciting feedback from staff and management, I want to foster a culture of collaboration. This fosters innovation on the team and opens minds to new points of view.
Charismatic leadership style
They have excellent communication skills.
Passionate in furthering Their Cause.
Professionals have a lot of experience in their field.
Act with a level head (Siangchokyoo, et al. 2020).
Leadership traits and behavior are under scrutiny.
Win Over Huge Crowds.
Possible drawbacks
Frustratingly Diminished Clarity
Not Enough People to Make It Happen
Charismatic leader
Charismatic leader example:
pr.
Need help on researching why women join gangs1.How does anxi.docxSusanaFurman449
Need help on researching why women join gangs
1.How does anxiety increase the chance of girls joining groups or gangs.
2. sexual abuse on girls joining gangs
3. long-term consequences on girls joining gangs
4. depression and anxiety impact on girls joining gangs
5.death rates of girls joining gangs
6. health risks of girls joining gangs
.
Jung Typology AssessmentThe purpose of this assignment is to ass.docxSusanaFurman449
Jung Typology Assessment
The purpose of this assignment is to assess your personality and how that information might help guide your career choice. Understanding personalities can also help managers know how to motivate employees.
Find out about your personality by going to the Human Metrics website (www.humanmetrics.com - and TAKE the Jung Typology Test - Jung, Briggs, Meyers Types. It is a free test. (Disclaimer: The test, like all other personality tests, is only a rough and preliminary indicator of personality.)
·
Complete the typology assessment
·
Read the corresponding personality portrait and career portrait.
·
Think about your career interests, then answer the following:
How are your traits compatible for your potential career choice (Business Administration)? This should be around 250 words of writing.
R E S E A R CH
Co-administration of multiple intravenous medicines: Intensive
care nurses' views and perspectives
Mosopefoluwa S. Oduyale MPharm1 | Nilesh Patel PhD, BPharm (Hons)1 |
Mark Borthwick MSc, BPharm (Hons)2 | Sandrine Claus PhD, MRSB, MRSC3
1Reading School of Pharmacy, University of
Reading, Reading, UK
2Pharmacy Department, John Radcliffe
Hospital, Oxford University Hospitals NHS
Foundation Trust, Oxford, UK
3LNC Therapeutics, Bordeaux, France
Correspondence
Mosopefoluwa S. Oduyale, Reading School of
Pharmacy, University of Reading, Harry
Nursten Building, Room 1.05, Whiteknights
Campus, Reading RG6 6UR, UK.
Email: [email protected]
Funding information
University of Reading
Abstract
Background: Co-administration of multiple intravenous (IV) medicines down the
same lumen of an IV catheter is often necessary in the intensive care unit (ICU) while
ensuring medicine compatibility.
Aims and objectives: This study explores ICU nurses' views on the everyday practice
surrounding co-administration of multiple IV medicines down the same lumen.
Design: Qualitative study using focus group interviews.
Methods: Three focus groups were conducted with 20 ICU nurses across two hospi-
tals in the Thames Valley Critical Care Network, England. Participants' experience of
co-administration down the same lumen and means of assessing compatibility were
explored. All focus groups were recorded, transcribed verbatim, and analysed using
thematic analysis. Functional Resonance Analysis Method was used to provide a
visual representation of the co-administration process.
Results: Two key themes were identified as essential during the process of co-admin-
istration, namely, venous access and resources. Most nurses described insufficient
venous access and lack of compatibility data for commonly used medicines (eg, anal-
gesics and antibiotics) as particular challenges. Strategies such as obtaining additional
venous access, prioritizing infusions, and swapping line of infusion were used to man-
age IV administration pro.
Journal of Organizational Behavior J. Organiz. Behav. 31, .docxSusanaFurman449
Journal of Organizational Behavior
J. Organiz. Behav. 31, 24–44 (2010)
Published online 22 May 2009 in Wiley InterScience
(www.interscience.wiley.com) DOI: 10.1002/job.621
Towards a multi-foci approach to
workplace aggression: A meta-analytic
review of outcomes from different
yperpetrators
M. SANDY HERSHCOVIS1* AND JULIAN BARLING2
1I. H. Asper School of Business, University of Manitoba, Winnipeg, Manitoba, Canada
2Queen’s School of Business, Queen’s University, Kingston, Ontario, Canada
Summary Using meta-analysis, we compare three attitudinal outcomes (i.e., job satisfaction, affective
commitment, and turnover intent), three behavioral outcomes (i.e., interpersonal deviance,
organizational deviance, and work performance), and four health-related outcomes (i.e.,
general health, depression, emotional exhaustion, and physical well being) of workplace
aggression from three different sources: Supervisors, co-workers, and outsiders. Results from
66 samples show that supervisor aggression has the strongest adverse effects across the
attitudinal and behavioral outcomes. Co-worker aggression had stronger effects than outsider
aggression on the attitudinal and behavioral outcomes, whereas there was no significant
difference between supervisor, co-worker, and outsider aggression for the majority of the
health-related outcomes. These results have implications for how workplace aggression is
conceptualized and measured, and we propose new research questions that emphasize a multi-
foci approach. Copyright # 2009 John Wiley & Sons, Ltd.
I admit that, before I was bullied, I couldn’t understand why employees would shy-away from doing
anything about it. When it happened to me, I felt trapped. I felt like either no one believed me or no
one cared. This bully was my direct boss and went out of his way to make me look and feel
incompetent. . . I dreaded going to work and cried myself to sleep every night. I was afraid of
losing my job because I started to question my abilities and didn’t think I’d find work elsewhere.
(HR professional as posted on a New York Times blog, 2008).
Introduction
Growing awareness of psychological forms of workplace aggression has stimulated research interest in
the consequences of these negative behaviors. Workplace aggression is defined as negative acts that are
* Correspondence to: M. Sandy Hershcovis, I. H. Asper School of Business, University of Manitoba, Winnipeg, Manitoba,
Canada. E-mail: [email protected]
yAn earlier version of this study was presented at the 65th Annual Meeting of the Academy of Management, Honolulu, HI.
Received 28 April 2008
Revised 17 March 2009
Copyright # 2009 John Wiley & Sons, Ltd. Accepted 4 April 2009
mailto:[email protected]
www.interscience.wiley.com
25 AGGRESSION META-ANALYSIS
perpetrated against an organization or its members and that victims are motivated to avoid (Neuman &
Baron, 2005; Raver & Barling, 2007). Much of this research (e.g., .
LDR535 v4Organizational Change ChartLDR535 v4Page 2 of 2.docxSusanaFurman449
LDR/535 v4
Organizational Change Chart
LDR/535 v4
Page 2 of 2
Organizational Change Chart
Organizational Information
Select an organization that needed a change to its culture as you complete the organizational change information chart.
For each type of information listed in the first column, include details about the organization in the second column.
Indicate your suggested actions for improvement in the third column.
Type
Details
Suggested Actions for Improvement
Vision
Insert the organization’s vision.
Mission
Insert the organization’s mission.
Purpose
Insert the organization’s purpose.
Values
Insert a list of the organization’s values.
Diversity and Equity
Insert the types of the diversity and equity observed in the organization.
Inclusion
Insert examples of overall involvement of diverse groups inclusion in decision-making and process change.
Goal
Identify the goal set for organizational change.
Strategy
Identify the implementation strategies followed to implement the organizational change.
Communication
Identify the communication methods used to communicate organizational change and the change progress.
Organizational Perceptions
Considering the same organizational culture and change goal, rate your agreement from 1 to 5 in the second column with the statement in the first column. Use the following scale:
1. Strongly disagree
2. Somewhat disagree
3. Neither agree nor disagree
4. Somewhat agree
5. Strongly agree
Statement
Rating (1 – 5)
Employees know the organization’s vision.
Employees know the organization’s mission.
Employees know the organization’s purpose.
Employees know the organization’s values.
Overall, the organization is diverse and equitable.
Diverse groups are included in decision making and processes for change.
The change goal was successfully met.
The implementation strategies were effective.
The organization’s communication about the change was effective.
Kotter's 8-Steps to Change
Consider the goal for organizational change that you identified and the existing organizational culture.
For each of Kotter's 8-Steps to Change listed in the first column, rate whether you observed that step during the implementation process in the second column. Use the following scale to rate your observation:
1. Never observed
2. Rarely observed
3. Sometimes observed
4. Often observed
Identify actions you suggest for improvement in the third column.
Step Name
Rating (1 – 4)
Suggested Actions for Improvement
Step 1: Create Urgency.
Step 2: Form a Powerful Coalition.
Step 3: Create a Vision for Change.
Step 4: Communicate the Vision.
Step 5: Remove Obstacles.
Step 6: Create Short-Term Wins.
Step 7: Build on the Change.
Step 8: Anchor the Changes in Corporate Culture.
Copyright 2022 by University of Phoenix. All rights reserved.
Copyright 2022 by University of Phoenix. All rights reserved.
image1.png
.
In this paper, you will select an ethics issue from among the topics.docxSusanaFurman449
In this paper, you will select an ethics issue from among the topics below and provide a 3-4 page paper on the issue.
In the paper, you will address the following:
1. Explain the topic (20%)
2. Why the topic or issue is controversial (25%)
3. Is the controversy justified? Why or why not? (20%)
4. Summarize current research about the issue and at least two credible sources. At least one reference source should discuss the issue from a pro and the other should discuss from a con perspective. (20%)
5. Cite references in APA format (15%)
Topics may include:
Research on animals
Medical Research on prisoners or ethnic minorities
Patient rights and HIPAA
Torture of military prisoners
Off-shore oil drilling and the potential threat to biodiversity
Development in emerging nations and its impact on biodiversity
Stem cell research
Healthcare Accessibility: Right or privilege
Genetically modified organisms
Genetic testing and data sharing
Reproductive rights
Pesticides and Agriculture
Organ transplants and accessibility
Assisted Suicide
Medicinal use of controlled substances/illicit drugs
.
In the past few weeks, you practiced observation skills by watchin.docxSusanaFurman449
In the past few weeks, you practiced observation skills by watching
Invictus, a movie that tells “the inspiring true story of how Nelson Mandela joined forces with the captain of South Africa's rugby team to help unite their country.”
[1]. While watching the film, you were instructed to pay special attention to the factors relating to group dynamics for teams, which include but are not limited to
1. Team beginnings
2. Leader’s behaviors,
3. Communication Patterns,
4. Conflict resolution style,
5. Power styles,
6. Decision making style,
7. Creativity,
8. Diversity.
You were also instructed to identify leadership decisions and leadership styles developed by Nelson Mandela and Francois Pinnear (captain of the rugby team).
Write a paper (1000 words) to the following three questions:
1. Which leadership decision/style has impressed you the most? Why do you feel this way?
2. How does the leader contribute to the development of their leadership ability?
3. What specific decisions made this leader make them such an effective leader? Provide insight on how those under this leadership are affected by decisions made.
.
Overview After analyzing your public health issue in Milestone On.docxSusanaFurman449
Overview: After analyzing your public health issue in Milestone One and studying socioeconomic factors affecting healthcare in this module, you will write a short paper to identify and analyze socioeconomic barriers and supports involved in addressing the public health issue. Your paper must include an introduction to your public health issue, a discussion of socioeconomic barriers to change, a discussion of supports for change, and a conclusion with a call to action for your readers. Assume your readers will include healthcare administrators and managers, as well as healthcare policy makers and legislators.
Prompt: Write a short paper including the following sections:
I. Introduction
A. Introduce your public health issue and briefly explain what needs to change to address the issue.
II. Barriers
A. Identify two potential socioeconomic barriers to change and describe each with specific details.
B. Consider patient demographics (e.g., age, ethnicity, and education), geographic factors (e.g., urban/rural location), and psychographic factors (e.g., eating habits and employment status).
C. Justify your points by referencing your textbook or other scholarly resources.
III. Supports
A. Identify two possible socioeconomic supports for change and describe each with specific details.
B. B. Consider patient demographics (e.g., age, ethnicity, and education), geographic factors (e.g., urban/rural location), and psychographic factors (e.g., eating habits and employment status).
C. C. Justify your points by referencing your textbook or other scholarly resources.
IV. Conclusion
A. Conclude with a clear call to action: What can your readers do to assist in the implementation of the necessary changes?
Rubric Guidelines for Submission: Your short paper must be submitted as a 2-page Microsoft Word document with double spacing, 12-point Times New Roman font, one-inch margins, and at least three sources cited in APA format.
.
Judicial OpinionsOverview After the simulation, justices writ.docxSusanaFurman449
Judicial Opinions
Overview: After the simulation, justices write judicial opinions in reaction to the oral argument, merits briefs, conference, and draft opinions as well as the facts of the case, Constitution, and case law. Justices circulate drafts so they know how their colleagues plan to rule and why, and so they can respond to one another in their final judicial opinion draft.
Instructions: You are a Supreme Court justice preparing an opinion for announcement. Read the case materials: case hypothetical, merits briefs, and judicial opinion drafts of your colleagues, and review your notes from oral argument and conference. Write a majority opinion resolving the major legal question in light of the facts of the case, Constitution, and case law, as well as all case materials: merits briefs, oral argument, and the views of your colleagues (in conference and draft opinions). Opinions must support an argument, refute counterarguments, and respond to attorneys (oral argument and/or merits briefs), and fellow justices (conference and/or draft opinions).
Opinions should contain the following five elements, in the following order:
1. an introductory statement of the nature, procedural posture, and prior result of the case;
2. a statement of the issues to be decided;
3. a statement of the material facts;
4. a discussion of the governing legal principles and resolution of the issues; and
5. the disposition and necessary instructions.
Each of these is developed further below.
Assessment: Complete opinions must support an argument, refute counterarguments, and respond to attorneys (oral argument and/or merits briefs), and fellow justices (conference and/or draft opinions). Strong opinions will be well organized, logically argued, and well supported through reference to and explanation of Supreme Court decisions and legal principles. Assessment rests on how well you make use of, identify, and explain relevant course material. It also rests on staying in character and not diverging from your justice’s political ideology and/or judicial philosophy.
Introduction
The purpose of the Introduction is to orient the reader to the case. It should state briefly what the case is about, the legal subject matter, and the result. It may also cover some or all of the following:
1. The parties: The parties should be identified, if not in the Introduction, then early in the opinion, preferably by name, and names should be used consistently throughout. (The use of legal descriptions, such as “appellant” and “appellee,” tends to be confusing, especially in multi-party cases.)
2. The procedural and jurisdictional status: relevant prior proceedings, and how the case got before the court should be outlined.
Statement of issues
The statement of issues is the cornerstone of the opinion; how the issues are formulated determines which facts are material and what legal principles govern. Judges should not be bound by the attorneys’.
IntroductionReview the Vila Health scenario and complete the int.docxSusanaFurman449
Introduction
Review the Vila Health scenario and complete the interviews with staff at Vila Health Skilled Nursing Facility (SNF). After completing the scenario, you will update the patient safety plan for the SNF and present it to the executive team. The safety plan will include meeting accrediting body requirements as well as regulatory obligations. The plan must be based on evidenced-based best practices and include tools, approaches, and mechanisms for reporting, tracking, and reducing patient safety incidents.
Instructions
After reviewing the Vila Health scenario, present your findings to the executive team at Vila Health by creating a 15-20 slide PowerPoint presentation. To be successful in this assignment, ensure you complete the following steps:
Research the health care organization's (Vila Health SNF) safety plan and propose recommendations to ensure the successes of their best practices.
Assess and propose how to link health care safety goals to those of the organizational strategic plan in order to create and sustain an organization-wide safety culture.
Analyze evidence-based practices within the organization's health care safety program, including falls prevention, medication errors, or others.
Establish protocols to identify and monitor patients who qualify for being at risk for falls, readmission, suicide, or others.
Develop mechanisms to coordinate and integrate risk management approaches into the organization's health care safety strategy.
Create mechanisms and tools as monitors for patients identified for being at risk.
Create ongoing evaluation procedures that provide continuous safe, quality patient care, and sustained compliance with evidence-based practices, professional standards, and regulations.
Submission Requirements
Your presentation should meet the following requirements:
Length:
15–20 slide PowerPoint presentation, excluding the cover slide and references list. Include slide numbers, headings, and running headers.
References:
3–5 current peer-reviewed references.
Format:
Use current APA style and formatting, for citations and references.
Font and font size:
Fonts and styles used should be consistent throughout the presentation, including headings.
.
In studying Social Problems, sociologists (and historians) identify .docxSusanaFurman449
This document discusses how sociologists identify defining moments that trigger the need for social change or resistance to the status quo in social problems. It asks the reader to provide context for a social issue, the defining moment that brought the issue into politics, and the resulting public policy.
I need help correcting an integrative review.This was the profes.docxSusanaFurman449
I need help correcting an integrative review.
This was the professor's feedback: Great job on your first draft :) Few things Past tense throughout the integrative review. Some of the sections are light on detail - need to check the requirements (Integrative review guidelines). This is an integrative review - not a study or project refer to it as an integrative review all the time.
.
How to Setup Warehouse & Location in Odoo 17 InventoryCeline George
In this slide, we'll explore how to set up warehouses and locations in Odoo 17 Inventory. This will help us manage our stock effectively, track inventory levels, and streamline warehouse operations.
How to Make a Field Mandatory in Odoo 17Celine George
In Odoo, making a field required can be done through both Python code and XML views. When you set the required attribute to True in Python code, it makes the field required across all views where it's used. Conversely, when you set the required attribute in XML views, it makes the field required only in the context of that particular view.
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
Temple of Asclepius in Thrace. Excavation resultsKrassimira Luka
The temple and the sanctuary around were dedicated to Asklepios Zmidrenus. This name has been known since 1875 when an inscription dedicated to him was discovered in Rome. The inscription is dated in 227 AD and was left by soldiers originating from the city of Philippopolis (modern Plovdiv).
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
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Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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Walmart Business+ and Spark Good for Nonprofits.pdfTechSoup
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The webinar may also give some examples on how nonprofits can best leverage Walmart Business+.
The event will cover the following::
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Special TechSoup offer for a free 180 days membership, and up to $150 in discounts on eligible orders.
Spark Good (walmart.com/sparkgood) is a charitable platform that enables nonprofits to receive donations directly from customers and associates.
Answers about how you can do more with Walmart!"
Level 3 NCEA - NZ: A Nation In the Making 1872 - 1900 SML.pptHenry Hollis
The History of NZ 1870-1900.
Making of a Nation.
From the NZ Wars to Liberals,
Richard Seddon, George Grey,
Social Laboratory, New Zealand,
Confiscations, Kotahitanga, Kingitanga, Parliament, Suffrage, Repudiation, Economic Change, Agriculture, Gold Mining, Timber, Flax, Sheep, Dairying,
Traditional Musical Instruments of Arunachal Pradesh and Uttar Pradesh - RAYH...
Here is a research tip We write the theory into a separate sectio
1. Here is a research tip: We write the theory into a separate
section in a research proposal so that readers can clearly
identify the theory from other components. Such a separate
passage provides a complete explication of the theory section,
its use, and how it relates to the study.
Writing a Quantitative Theoretical Perspective
Using these ideas, the following presents a model for writing a
quantitative theoretical perspective section into a research plan.
Assume that the task is to identify a theory that explains the
relationship between independent and dependent variables.
Look in the discipline-based literature for a theory. If the unit
of analysis for variables is an individual, look in the psychology
literature; to study groups or organizations, look in the
sociological literature. If the project examines individuals and
groups, consider the social psychology literature. Of course,
theories from other disciplines may be useful, too (e.g., to study
an economic issue, the theory may be found in economics).
Examine also prior studies that address the topic or a closely
related topic. What theories did the authors use? Limit the
number of theories and try to identify one overarching theory
that explains the central hypothesis or major research question.
As mentioned earlier, ask the rainbow question that bridges the
independent and dependent variables: What explains why the
independent variable(s) would influence the dependent
variables?
Script out the theory section. Follow these lead sentences: “The
theory that I will use is _____ (name the theory). It was
developed by _____ (identify the origin, source, or developer of
the theory), and it was used to study _____ (identify the topics
where one finds the theory being applied). This theory indicates
that _____ (identify the propositions or hypotheses in the
2. theory). As applied to my study, this theory holds that I would
expect my independent variable(s) _____ (state independent
variables) to influence or explain the dependent variable(s)
_____ (state dependent variables) because _____ (provide a
rationale based on the logic of the theory).”
Thus, the topics to include in a quantitative theory discussion
are the theory to be used, its central hypotheses or propositions,
information about past use of the theory and its application, and
statements that reflect how it relates to a proposed study.
Example 3.1, which contains a passage by Crutchfield (1986)
from her dissertation, illustrates the use of this model.
Theory
at a
Glance
A Guide For Health Promotion Practice
(Second Edition)
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health
Foreword
3. A
decade ago, the first edition of Theory at a Glance was
published. The guide was
a welcome resource for public health practitioners seeking a
single, concise
summary of health behavior theories that was neither
overwhelming nor superficial.
As a government publication in the public domain, it also
provided cash-strapped
health departments with access to a seminal integration of
scholarly work that was useful to
program staff, interns, and directors alike. Although they were
not the primary target audience,
members of the public health research community also utilized
Theory at a Glance, both as
a quick desk reference and as a primer for their students.
The National Cancer Institute is pleased to sponsor the
publication of this guide, but its
relevance is by no means limited to cancer prevention and
control. The principles described
herein can serve as frameworks for many domains of public
health intervention,
complementing focused evidence reviews such as Centers for
Disease Control and
Prevention’s Guide to Community Preventive Services. This
report also complements a
number of other efforts by NCI and our federal partners to
facilitate more rigorous testing
and application of health behavior theories through training
workshops and the development
of new Web-based resources.
One reason theory is so useful is that it helps us articulate
assumptions and hypotheses
4. concerning our strategies and targets of intervention. Debates
among policymakers
concerning public health programs are often complicated by
unspoken assumptions or
confusion about which data are relevant. Theory can inform
these debates by clarifying key
constructs and their presumed relationships. Especially when
the evidence base is small,
advocates of one approach or another can be challenged to
address the mechanisms by
which a program is expected to have an impact. By specifying
these alternative pathways to
change, program evaluations can be designed to ensure that
regardless of the outcome,
improvements in knowledge, program design, and
implementation will occur.
I am pleased to introduce this second edition of Theory at a
Glance. I am especially
impressed that the lead authors, Dr. Barbara K. Rimer and Dr.
Karen Glanz, have enhanced
and updated it throughout without diminishing the clarity and
efficiency of the original. We
hope that this new edition will empower another generatio n of
public health practitioners to
apply the same conceptual rigor to program planning and design
that these authors exemplify
in their own research and practice.
Robert T. Croyle, Ph.D.
Director
Division of Cancer Control and Population Sciences
National Cancer Institute
5. Spring 2005
Acknowledgements
The National Cancer Institute would like to thank Barbara
Rimer Dr.P.H. and
Karen Glanz Ph.D., M.P.H., authors of the original monograph,
whose knowledge of
healthcommunications theory and practice have molded a
generation of health promotion
practitioners. Both have provided hours of review and
consultation, and we are grateful to
them for their contributions.
Thanks to the staffs of the Office of Communications,
particularly Margaret Farrell,
and the Division of Cancer Control and Population Sciences and
Kelly Blake, who guided
this monograph to completion. We appreciate in particular the
work of Karen Harris,
whose attention to detail and commitment to excellence
enhanced the monograph’s
content and quality.
Tables and Figures
Table of Contents
Introduction viii
6. Audience and Purpose 1
Contents 1
Part 1: Foundations of Theory in Health Promotion and Health
Behavior 3
Why Is Theory Important to Health Promotion and Health
Behavior Practice? 4
What Is Theory? 4
How Can Theory Help Plan Effective Programs? 4
Explanatory Theory and Change Theory 5
Fitting Theory to the Field of Practice 5
Using Theory to Address Health Issues in Diverse Populations 7
Part 2: Theories and Applications 9
The Ecological Perspective: A Multilevel, Interactive Approach
10
Theoretical Explanations of Three Levels of Influence 12
Individual or Intrapersonal Level 12
7. Health Belief Model 13
Stages of Change Model 15
Theory of Planned Behavior 16
Precaution Adoption Process Model 18
Interpersonal Level 19
Social Cognitive Theory 19
Community Level 22
Community Organization and Other Participatory Models 23
Diffusion of Innovations 27
Communication Theory 29
Media Effects 30
Agenda Setting 30
New Communication Technologies 31
Part 3: Putting Theory and Practice Together 35
8. Planning Models 36
Social Marketing 36
PRECEDE-PROCEED 39
Where to Begin: Choosing the Right Theories 43
A Few Final Words 44
Sources 48
References 49
Table 1
Table 2
Table 3
Table 4
Table 5
Table 6
Table 7
Table 8
9. Table 9
Table 10
Table 11
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
Figure 7
Figure 8
Figure 9
Figure 10
Tables
An Ecological Perspective: Levels of Influence 11
Health Belief Model 14
Stages of Change Model 15
10. Theory of Planned Behavior 17
Social Cognitive Theory 20
Community Organization 24
Concepts in Diffusion of Innovations 27
Key Attributes Affecting the Speed and Extent of an
Innovation’s Diffusion 28
Agenda Setting, Concepts, Definitions, and Applications 31
Diagnostic Elements of PRECEDE-PROCEED 42
Summary of Theories: Focus and Key Concepts 45
Figures
Using Explanatory Theory and Change Theory to Plan and
Evaluate Programs 6
A Multilevel Approach to Epidemiology 10
Theory of Reasoned Action and Theory of Planned Behavior 18
Stages of the Precaution Adoption Process Model 19
11. An Integrative Model 21
Sociocultural Environment Logic Framework 26
An Asthma Self-Management Video Game for Children 33
Social Marketing Wheel 38
The PRECEDE-PROCEED Model 40
Using Theory to Plan Multilevel Interventions 46
viii
T
H
E
O
R
Y
A
T
A
G
12. L A
N
C
E
Introduction
T
his monograph, Theory at a Glance: Application to Health
Promotion and Health
Behavior (Second Edition), describes influential theories of
health-related behaviors,
processes of shaping behavior, and the effects of community
and environmental
factors on behavior. It complements existing resources that
offer tools, techniques,
and model programs for practice, such as Making Health
Communication Programs Work:
A Planner’s Guide, i and the Web portal, Cancer Control
PLANET (Plan, Link, Act, Network
with Evidence-based Tools).ii Theory at a Glance makes health
behavior theory accessible
and provides tools to solve problems and assess the
effectiveness of health promotion
programs. (For the purposes of this monograph, health
promotion is broadly defined as the
process of enabling people to increase control over, and to
improve, their health. Thus, the
focus goes beyond traditional primary and secondary prevention
programs.)
13. For nearly a decade, public health and health care practitioners
have consulted the original
version of Theory at a Glance for guidance on using theories
about human behavior to inform
program planning, implementation, and evaluation. We have
received many testimonials
about the First Edition’s usefulness, and requests for additional
copies. This updated edition
includes information from recent health behavior research and
suggests theoretical
approaches to developing programs for diverse populations.
Theory at a Glance can be
used as a stand-alone handbook, as part of in-house staff
development programs, or in
conjunction with theory texts and continuing education
workshops.
For easy reference, the monograph includes only a small number
of current and applicable
health behavior theories. The theories reviewed here are widely
used for the purposes of
cancer control, defining risk, and segmenting populations. Much
of the content for this
publication has been adapted from the third edition of Glanz,
Rimer, and Lewis’ Health
Behavior and Health Education: Theory, Research, and Practice,
1 published by Jossey-Bass
in San Francisco. Readers who want to learn more about useful
theories for health behavior
change and health education practice can consult this and other
sources that are
recommended in the References section at the end of the
monograph.
i Making Health Communication Programs Work
(http://www.nci.nih.gov/pinkbook/) describes a practical
14. approach for planning and implementing health communication
efforts.
ii Cancer Control PLANET
(http://cancercontrolplanet.cancer.gov) provides access to data
and resources
that can help planners, program staff, and researchers to design,
implement, and evaluate evidence-based
cancer control programs.
Audience and Purpose
This monograph is written primarily for public health workers
in state and local health
agencies; it is also valuable for health promotion practitioners
and volunteers who work in
voluntary health agencies, community organizations, health care
settings, schools, and the
private sector.
Interventions based on health behavior theory are not
guaranteed to succeed, but they are
much more likely to produce desired outcomes. Theory at a
Glance is designed to help users
understand how individuals, groups, and organizations behave
and change—knowledge they
can use to design effective programs. For information about
specific, evidence-based
interventions to promote health and prevent disease, readers
may also wish to consult the
Guide to Community Preventive Services, published by the
Centers for Disease Control and
Prevention (CDC) at www.thecommunityguide.org.
Contents
15. This monograph consists of three parts. For each theory, the
text highlights key concepts
and their applications. These summaries may be used as
“checklists” of important issues to
consider when planning or evaluating programs or to prompt
project teams to think about the
range of factors that influence health behavior.
Part 1. Foundations of Theory in Health Promotion and Health
Behavior describes ways that
theories and models can be useful in health behavior/health
promotion practice and
provides basic definitions.
Part 2. Theories and Applications presents an ecological
perspective on health
behavior/health promotion programs. It describes eight theories
and models that
explain individual, interpersonal, and community behavior and
offers approaches to
solving problems. A brief description of each theory is followed
by definitions of key
concepts and examples or case studies. The section also
explores the use of new
communication technologies.
Part 3. Putting Theory and Practice Together explains how
theory can be used in health
behavior/health promotion program planning, implementation,
and evaluation.
Two comprehensive planning models, PRECEDE-PROCEED
and social marketing,
are reviewed.
1
19. and chronic disease management programs
help people maintain and improve health,
reduce disease risks, and manage chronic
illness. They can improve the well-being
and self-sufficiency of individuals, families,
organizations, and communities. Usually,
such successes require behavior change at
many levels, (e.g., individual, organizational,
and community).
Not all health programs and initiatives are
equally successful, however. Those most
likely to achieve desired outcomes are
based on a clear understanding of targeted
health behaviors, and the environmental
context in which they occur. Practitioners
use strategic planning models to develop
and manage these programs, and
continually improve them through
meaningful evaluation. Health behavior
theory can play a critical role throughout
the program planning process.
What Is Theory?
A theory presents a systematic way of
understanding events or situations. It is a
set of concepts, definitions, and propositions
that explain or predict these events or
situations by illustrating the relationships
between variables. Theories must be
applicable to a broad variety of situations.
They are, by nature, abstract, and don’t
have a specified content or topic area.
Like empty coffee cups, theories have
shapes and boundaries, but nothing inside.
20. They become useful when filled with
practical topics, goals, and problems.
• Concepts are the building blocks—the
primary elements—of a theory.
• Constructs are concepts developed or
adopted for use in a particular theory.
The key concepts of a given theory are
its constructs.
• Variables are the operational forms of
constructs. They define the way a
construct is to be measured in a specific
situation. Match variables to constructs
when identifying what needs to be
assessed during evaluation of a theory-
driven program.
• Models may draw on a number of theories
to help understand a particular problem in
a certain setting or context. They are not
always as specified as theory.
Most health behavior and health promotion
theories were adapted from the social and
behavioral sciences, but applying them to
health issues often requires that one be
familiar with epidemiology and the biological
sciences. Health behavior and health
promotion theories draw upon various
disciplines, such as psychology, sociology,
anthropology, consumer behavior, and
marketing. Many are not highly developed
or have not been rigorously tested. Because
of this, they often are called conceptual
21. frameworks or theoretical frameworks; here
the terms are used interchangeably.
How Can Theory Help Plan
Effective Programs?
Theory gives planners tools for moving
beyond intuition to design and evaluate
health behavior and health promotion
interventions based on understanding of
behavior. It helps them to step back and
consider the larger picture. Like an artist,
a program planner who grounds health
interventions in theory creates innovative
ways to address specific circumstances.
He or she does not depend on a “paint-by-
numbers” approach, re-hashing stale ideas,
but uses a palette of behavior theories,
skillfully applying them to develop unique,
tailored solutions to problems.
Using theory as a foundation for program
planning and development is consistent with
the current emphasis on using evidence-
based interventions in public health,
behavioral medicine, and medicine. Theory
provides a road map for studying problems,
developing appropriate interventions, and
evaluating their successes. It can inform the
planner’s thinking during all of these stages,
offering insights that translate into stronger
programs. Theory can also help to explain
the dynamics of health behaviors, including
processes for changing them, and the
influences of the many forces that affect
22. health behaviors, including social and
physical environments. Theory can also help
planners identify the most suitable target
audiences, methods for fostering change,
and outcomes for evaluation.
Researchers and practitioners use theory
to investigate answers to the questions of
“why,” “what,” and “how” health problems
should be addressed. By seeking answers
to these questions, they clarify the nature
of targeted health behaviors. That is, theory
guides the search for reasons why people
do or do not engage in certain health
behaviors; it helps pinpoint what planners
need to know before they develop public
health programs; and it suggests how to
devise program strategies that reach target
audiences and have an impact. Theory also
helps to identify which indicators should be
monitored and measured during program
evaluation. For these reasons, program
planning, implementation, and monitoring
processes based in theory are more likely
to succeed than those developed without
the benefit of a theoretical perspective.
Explanatory Theory and
Change Theory
Explanatory theory describes the reasons
why a problem exists. It guides the search
for factors that contribute to a problem (e.g.,
a lack of knowledge, self-efficacy, social
support, or resources), and can be changed.
23. Examples of explanatory theories include
the Health Belief Model, the Theory of
Planned Behavior, and the Precaution
Adoption Process Model.
Change theory guides the development of
health interventions. It spells out concepts
that can be translated into program
messages and strategies, and offers a basis
for program evaluation. Change theory
helps program planners to be explicit about
their assumptions for why a program will
work. Examples of change theories include
Community Organization and Diffusion of
Innovations. Figure 1. illustrates how
explanatory theory and change theory can
be used to plan and evaluate programs.
Fitting Theory to the Field of Practice
This monograph includes descriptions and
applications of some theories that are
central to health behavior and health
promotion practice today. No single theory
dominates health education and promotion,
nor should it; the problems, behaviors,
populations, cultures, and contexts of public
health practice are broad and varied. Some
theories focus on individuals as the unit of
change. Others examine change within
families, institutions, communities, or
cultures. Adequately addressing an issue
may require more than one theory, and no
one theory is suitable for all cases.
5
27. ure 1. Using Explanatory Theory and Change Theory to Plan
and Evaluate Programs
Evaluation
ChangeTheory
Problem
Behavior Which strategies?
Which messages? or
Assumptions about
Situation how a program
should work
Planning
A Good Fit:
Characteristics of a Useful Theory
A useful theory makes assumptions about
a behavior, health problem, target
population, or environment that are:
• Logical;
• Consistent with everyday observations;
• Similar to those used in previous
successful programs; and
• Supported by past research in the same
area or related ideas.
Using Theory to Address Health
28. Issues in Diverse Populations
The U.S. population is growing more
culturally and ethnically diverse. An
increasing body of research shows health
disparities exist among various ethnic and
socio-economic groups. These findings
highlight the importance of understanding
Because the social context in which
behavior occurs is always evolving, theories
that were important in public health
education a generation ago may be of
limited use today. At the same time, new
social science research allows theorists to
refine and adapt existing theories. A recent
Institute of Medicine report2 observed that
several theorists have converged in their
views, identifying several variables as
central to behavior change. As a result,
some constructs, such as self-efficacy, are
central to multiple theories.
Effective practice depends on using
theories and strategies that are appropriate
to a situation.
One of the greatest challenges for those
concerned with behavior change is learning
to analyze how well a theory or model “fits”
a particular issue. A working knowledge of
specific theories, and familiarity with how
they have been applied in the past,
improves skills in this area. Selecting an
appropriate theory or combination of
29. theories helps take into account the multiple
factors that influence health behaviors.
The practitioner who uses theory develops a
nuanced understanding of realistic program
outcomes that drives the planning process.
Choosing a theory that will bring a useful
perspective to the problem at hand does not
begin with a theory (e.g., the most familiar
theory, the theory mentioned in a recent
journal article, etc.). Instead, this process
starts with a thorough assessment of the
situation: the units of analysis or change,
the topic, and the type of behavior to be
addressed. Because different theoretical
frameworks are appropriate and practical for
different situations, selecting a theory that
“fits” should be a careful, deliberate process.
Start with the steps in the box at the top of
the next page.
the cultural backgrounds and life
experiences of community members, though
research has not yet established when and
under what circumstances targeted or
tailored health communications are more
effective than generic ones. (Targeting
involves using information about shared
characteristics of a population subgroup to
create a single intervention approach for
that group. In contrast, tailoring is a process
that uses an assessment to derive
information about one specific person, and
then offers change or information strategies
for an outcome of interest based on that
person’s unique characteristics.)3
30. Most health behavior theories can be
applied to diverse cultural and ethnic
groups, but health practitioners must
understand the characteristics of target
populations (e.g., ethnicity, socioeconomic
status, gender, age, and geographical
location) to use these theories correctly.
There are several reasons why culture and
ethnicity are critical to consider when
applying theory to a health problem. First,
morbidity and mortality rates for different
diseases vary by race and ethnicity; second,
there are differences in the prevalence of
risk behaviors among these groups; and
third, the determinants of health behaviors
vary across racial and ethnic groups.
What People in the Field Say About Theory
“Theory is different from most of the tools
I use in my work. It’s more abstract, but
that can be a plus too. A solid grounding
in a handful of theories goes a long way
toward helping me think through why I
approach a health problem the way I do.”
— County Health Educator
“I used to think theory was just for
students and researchers. But now I have
a better grasp of it; I appreciate how
practical it can be.”
— State Chronic Disease Administrator
31. “By translating concepts from theory
into real-world terms, I can get my staff
and community volunteers to take a closer
look at why we’re conducting programs
the way we do, and how they can succeed
or fail.”
— City Tobacco Control Coordinator
“A good grasp of theory is essential for
leadership. It gives you a broader way
of viewing your work. And it helps create
a vision for the future. But, of course, it’s
only worthwhile if I can translate it clearly
and simply to my co-workers.”
— Regional Health Promotion Chief
“It’s not as hard as I thought it would be
to keep up with current theories. More
than ever these days, there are tools and
workshops to update us often.”
— Patient Education Coordinator
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The Ecological Perspective: A interactions with their physical
and socio-
cultural environments. Two key concepts Multilevel, Interactive
Approach
of the ecological perspective help to identify
35. intervention points for promoting health:Contemporary health
promotion involves
first, behavior both affects, and is affected
Concept Definition
Intrapersonal Level Individual characteristics that influence
behavior, such as
knowledge, attitudes, beliefs, and personality traits
Interpersonal Level Interpersonal processes and primary groups,
including
family, friends, and peers that provide social identity,
support, and role definition
Community Level
Institutional Factors
Rules, regulations, policies, and informal structures, which
may constrain or promote recommended behaviors
Community Factors
Social networks and norms, or standards, which exist as
formal or informal among individuals, groups, and
organizations
Public Policy Local, state, and federal policies and laws that
regulate
or support healthy actions and practices for disease
prevention, early detection, control, and management
by, multiple levels of influence; second,
Table 1. An Ecological Perspective: Levels of Influence
more than simply educating individuals
36. about healthy practices. It includes efforts
individual behavior both shapes, and isto change organizational
behavior, as well
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shaped by, the social environment as the physical and social
environment of
communities. It is also about developing and (reciprocal
causation).
advocating for policies that support health,
such as economic incentives. Health
promotion programs that seek to address
health problems across this spectrum
employ a range of strategies, and operate
on multiple levels.
The ecological perspective emphasizes the
interaction between, and interdependence
of, factors within and across all levels of a
health problem. It highlights people’s
To explain the first key concept of the
ecological perspective, multiple levels of
influence, McLeroy and colleagues (1988)4
identified five levels of influence for health-
related behaviors and conditions. Defined
in Table 1., these levels include: (1)
intrapersonal or individual factors; (2)
interpersonal factors; (3) institutional or
organizational factors; (4) community
factors; and (5) public policy factors.
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Figure 2. A Multilevel Approach to Epidemiology
Social and Economic Policies
Institutions
Neighborhoods and Communities
Living Conditions
Social Relationships
Individual Risk Factors
39. Pathophysiological
Pathways
Individual/Population
Health
Genetic/Constitutional
Factors
Envir
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Li
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In practice, addressing the community level
requires taking into consideration
institutional and public policy factors, as well
as social networks and norms. Figure 2.
illustrates how different levels of influence
combine to affect population health.
Each level of influence can affect health
behavior. For example, suppose a woman
delays getting a recommended
mammogram (screening for breast cancer).
At the individual level, her inaction may be
40. due to fears of finding out she has cancer.
At the interpersonal level, her doctor may
neglect to tell her that she should get the
test, or she may have friends who say they
do not believe it is important to get a
mammogram. At the organizational level,
it may be hard to schedule an appointment,
because there is only a part-time radiologist
at the clinic. At the policy level, she may
lack insurance coverage, and thus be
unable to afford the fee. Thus, the outcome,
the woman’s failure to get a mammogram,
may result from multiple factors.
The second key concept of an ecological
perspective, reciprocal causation, suggests
that people both influence, and are
influenced by, those around them. For
example, a man with high cholesterol may
find it hard to follow the diet his doctor has
prescribed because his company cafeteria
doesn’t offer healthy food choices. To
comply with his doctor’s instructions, he can
try to change the environment by asking the
cafeteria manager to add healthy items to
the menu, or he can dine elsewhere. If he
and enough of his fellow employees decide
to find someplace else to eat, the cafeteria
may change its menu to maintain lunch
business. Thus, the cafeteria environment
may compel this man to change his dining
habits, but his new habits may ultimately
bring about change in the cafeteria as well.
41. Source: Smedley BD, Syme SL (eds.), Institute of Medicine.
Promoting Health: Strategies from Social and Behavioral
Research. Washington, D.C.:, National Academies Press, 2000.
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An ecological perspective shows the
advantages of multilevel interventions that
combine behavioral and environmental
42. components. For instance, effective
tobacco control programs often use
multiple strategies to discourage smoking.5
Employee smoking cessation clinics have
a stronger impact if the workplace has a
no-smoking policy and the city has a clean
indoor air ordinance. Adolescents are
less likely to begin smoking if their
peers disapprove of the habit and laws
prohibiting tobacco sales to minors
are strictly enforced. Health promotion
programs are more effective when
planners consider multiple levels of
influence on health problems.
Theoretical Explanations of Three
Levels of Influence
The next three sections examine
theories and their applications at the
individual (intrapersonal), interpersonal,
and community levels of the ecological
perspective. At the individual and
interpersonal levels, contemporary theories
of health behavior can be broadly
categorized as “Cognitive-Behavioral.”
Three key concepts cut across
these theories:
1. Behavior is mediated by cognitions; that
is, what people know and think affects
how they act.
2. Knowledge is necessary for, but not
sufficient to produce, most behavior
43. changes.
3. Perceptions, motivations, skills, and
the social environment are key influences
on behavior.
Community-level models offer frameworks
for implementing multi-dimensional
approaches to promote healthy behaviors.
They supplement educational approaches
with efforts to change the social and
physical environment to support positive
behavior change.
Individual or Intrapersonal Level
The individual level is the most basic one
in health promotion practice, so planners
must be able to explain and influence the
behavior of individuals. Many health
practitioners spend most of their work time
in one-on-one activities such as counseling
or patient education, and individuals are
often the primary target audience for health
education materials. Because individual
behavior is the fundamental unit of group
behavior, individual-level behavior change
theories often comprise broader-level
models of group, organizational, community,
and national behavior. Individuals participate
in groups, manage organizations, elect and
appoint leaders, and legislate policy. Thus,
achieving policy and institutional change
requires influencing individuals.
In addition to exploring behavior, individual-
44. level theories focus on intrapersonal factors
(those existing or occurring within the
individual self or mind). Intrapersonal
factors include knowledge, attitudes,
beliefs, motivation, self-concept,
developmental history, past experience,
and skills. Individual-level theories are
presented below.
• The Health Belief Model (HBM) addresses
the individual’s perceptions of the threat
posed by a health problem (susceptibility,
severity), the benefits of avoiding the
threat, and factors influencing the
decision to act (barriers, cues to action,
and self-efficacy).
• The Stages of Change (Transtheoretical)
Model describes individuals’ motivation
and readiness to change a behavior.
• The Theory of Planned Behavior (TPB)
examines the relations between an
individual’s beliefs, attitudes, intentions,
behavior, and perceived control over
that behavior.
• The Precaution Adoption Process Model
(PAPM) names seven stages in an
individual’s journey from awareness to
action. It begins with lack of awareness
and advances through subsequent stages
of becoming aware, deciding whether
or not to act, acting, and maintaining
the behavior.
45. Health Belief Model (HBM)
The Health Belief Model (HBM) was one
of the first theories of health behavior, and
remains one of the most widely recognized
in the field. It was developed in the 1950s
by a group of U.S. Public Health Service
social psychologists who wanted to explain
why so few people were participating in
programs to prevent and detect disease.
For example, the Public Health Service was
sending mobile X-ray units out to
neighborhoods to offer free chest X-rays
(screening for tuberculosis). Despite the fact
that this service was offered without charge
in a variety of convenient locations, the
program was of limited success. The
question was, “Why?”
To find an answer, social psychologists
examined what was encouraging or
discouraging people from participating in
the programs. They theorized that people’s
beliefs about whether or not they were
susceptible to disease, and their
perceptions of the benefits of trying to
avoid it, influenced their readiness to act.
In ensuing years, researchers expanded
upon this theory, eventually concluding that
six main constructs influence people’s
decisions about whether to take action to
prevent, screen for, and control illness. They
argued that people are ready to act if they:
• Believe they are susceptible to the
condition (perceived susceptibility)
46. • Believe the condition has serious
consequences (perceived severity)
• Believe taking action would reduce their
susceptibility to the condition or its severity
(perceived benefits)
• Believe costs of taking action (perceived
barriers) are outweighed by the benefits
• Are exposed to factors that prompt action
(e.g., a television ad or a reminder from
one’s physician to get a mammogram)
(cue to action)
• Are confident in their ability to successfully
perform an action (self-efficacy)
Since health motivation is its central focus,
the HBM is a good fit for addressing
problem behaviors that evoke health
concerns (e.g., high-risk sexual behavior
and the possibility of contracting HIV).
Together, the six constructs of the HBM
provide a useful framework for designing
both short-term and long-term behavior
change strategies. (See Table 2.) When
applying the HBM to planning health
programs, practitioners should ground their
efforts in an understanding of how
susceptible the target population feels to the
health problem, whether they believe it is
serious, and whether they believe action
can reduce the threat at an acceptable cost.
Attempting to effect changes in these factors
47. is rarely as simple as it may appear.
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48. Table 2. Health Belief Model
Stages of Change (Transtheoretical) Model of change.
Nonetheless, the manner in
Developed by Prochaska and DiClemente,6 which they pass
through these stages may
the Stages of Change Model evolved out vary, depending on the
type of behavior
of studies comparing the experiences of change. For example, a
person who is tryingConcept Definition Potential Change
Strategies
Perceived Beliefs about the chances • Define what
populations(s) are at risk and
susceptibility of getting a condition their levels of risk
• Tailor risk information based on an
individual’s characteristics or behaviors
• Help the individual develop an accurate
perception of his or her own risk
Perceived severity Beliefs about the • Specify the
consequences of a condition
seriousness of a condition and recommended action
and its consequences
Perceived benefits Beliefs about the • Explain how, where,
and when to take
49. effectiveness of taking action and what the potential positive
action to reduce risk or results will be
seriousness
Perceived barriers Beliefs about the material • Offer
reassurance, incentives, and
and psychological costs assistance; correct misinformation
of taking action
Cues to action Factors that activate • Provide ”how to”
information, promote
”readiness to change” awareness, and employ reminder systems
Self-efficacy Confidence in one’s ability • Provide training and
guidance in
to take action performing action
• Use progressive goal setting
• Give verbal reinforcement
• Demonstrate desired behaviors
smokers who quit on their own with those
of smokers receiving professional treatment.
The model’s basic premise is that behavior
change is a process, not an event. As a
person attempts to change a behavior, he
or she moves through five stages:
precontemplation, contemplation,
preparation, action, and maintenance (see
Table 3.). Definitions of the stages vary
slightly, depending on the behavior at issue.
People at different points along this
continuum have different informational
needs, and benefit from interventions
designed for their stage.
50. Whether individuals use self-management
methods or take part in professional
programs, they go through the same stages
Table 3. Stages of Change Model
to give up smoking may experience the
stages differently than someone who is
seeking to improve their dietary habits by
eating more fruits and vegetables.
The Stages of Change Model has been
applied to a variety of individual behaviors,
as well as to organizational change. The
Model is circular, not linear. In other words,
people do not systematically progress from
one stage to the next, ultimately
“graduating” from the behavior change
process. Instead, they may enter the
change process at any stage, relapse to
an earlier stage, and begin the process
once more. They may cycle through this
process repeatedly, and the process can
truncate at any point.
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Stage Definition Potential Change Strategies
Precontemplation Has no intention of taking
action within the next
six months
Increase awareness of need for change;
personalize information about risks
and benefits
Contemplation Intends to take action in
the next six months
Motivate; encourage making specific plans
Preparation Intends to take action
within the next thirty
days and has taken some
behavioral steps in
this direction
Assist with developing and implementing
concrete action plans; help set
53. gradual goals
Action Has changed behavior for
less than six months
Assist with feedback, problem solving,
social support, and reinforcement
Maintenance Has changed behavior for
more than six months
Assist with coping, reminders, finding
alternatives, avoiding slips/relapses
(as applicable)
High blood pressure screening campaigns often identify people
who are at high risk for heart
disease and stroke, but who say they have not experienced any
symptoms. Because they don’t
feel sick, they may not follow instructions to take prescribed
medicine or lose weight. The
HBM can be useful for developing strategies to deal with
noncompliance in such situations.
According to the HBM, asymptomatic people may not follow a
prescribed treatment regimen
unless they accept that, though they have no symptoms, they do
in fact have hypertension
(perceived susceptibility). They must understand that
hypertension can lead to heart attacks
and strokes (perceived severity). Taking prescribed medication
or following a recommended
weight loss program will reduce the risks (perceived benefits)
without negative side effects
or excessive difficulty (perceived barriers). Print materials,
reminder letters, or pill calendars
54. might encourage people to consistently follow their doctors’
recommendations (cues to
action). For those who have, in the past, had a hard time losing
weight or maintaining
weight loss, a behavioral contract might help establish
achievable, short-term goals to build
confidence (self-efficacy).
Suppose a large company hires a health educator to plan a
smoking cessation program
for its employees who smoke (200 people). The health educator
decides to offer group
smoking cessation clinics to employees at various times and
locations. Several months
pass, however, and only 50 of the smokers sign up for the
clinics. At this point, the
health educator faces a dilemma: how can the 150 smokers who
are not participating
in the clinics be reached?
The Stages of Change Model offers perspective on ways to
approach this problem. First,
the model can be employed to help understand and explain why
they are not attending
the clinics. Second, it can be used to develop a comprehensive
smoking program to help
more current and former smokers change their smoking
behavior, and maintain that
change. By asking a few simple questions, the health educator
can assess what stages
of contemplation potential program participants are in. For
55. example:
• Are you interested in trying to quit smoking? (Pre-
contemplation)
• Are you thinking about quitting smoking soon?
(Contemplation)
• Are you ready to plan how you will quit smoking?
(Preparation)
• Are you in the process of trying to quit smoking? (Action)
• Are you trying to stay smoke-free? (Maintenance)
The employees’ responses will help to pinpoint where the
participants are on the
continuum of change, and to tailor messages, strategies, and
programs appropriate to
their needs. For example, individuals who enjoy smoking are
not interested in trying to
quit, and therefore will not attend a smoking cessation clinic;
for them, a more
appropriate intervention might include educational interventions
designed to move
them out of the “precontemplation” stage and into
“contemplation” (e.g., using carbon
monoxide testing to demonstrate the effect of smoking on
health). On the other hand,
individuals who are ready to plan how to quit smoking (the
“preparation” stage) can be
encouraged to do so, and moved to the next stage, “action.”
a particular behavior. Azjen and Driver7 situations, however.
People’s perceptions
added this construct to account for about controllability may
56. have an important
situations in which people’s behavior, or influence on behavior.
behavioral intention, is influenced by factors
beyond their control. They argued that
people might try harder to perform a
behavior if they feel they have a high
degree of control over it. (See Table 4.)
It has application beyond these limited
Table 4. Theory of Planned Behavior
Concept Definition Measurement Approach
Behavioral intention Perceived likelihood of performing
behavior
Are you likely or unlikely to
(perform the behavior)?
Attitude Personal evaluation of the behavior Do you see (the
behavior) as
good, neutral, or bad?
Subjective norm Beliefs about whether key people
approve or disapprove of the
behavior; motivation to behave in a
way that gains their approval
Do you agree or disagree that
most people approve
of/disapprove of (the behavior)?
Perceived behavioral
control
Belief that one has, and can exercise,
57. control over performing the behavior
Do you believe (performing the
behavior) is up to you, or not
up to you?
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Theory of Planned Behavior (TPB)
The Theory of Planned Behavior (TPB) and
the associated Theory of Reasoned Action
(TRA) explore the relationship between
behavior and beliefs, attitudes, and
intentions. Both the TPB and the TRA
59. assume behavioral intention is the most
important determinant of behavior.
According to these models, behavioral
intention is influenced by a person’s attitude
toward performing a behavior, and by beliefs
about whether individuals who are important
to the person approve or disapprove of the
behavior (subjective norm). The TPB and
TRA assume all other factors (e.g., culture,
the environment) operate through the
models’ constructs, and do not
independently explain the likelihood that
a person will behave a certain way.
The TPB differs from the TRA in that it
includes one additional construct, perceived
behavioral control; this construct has to
do with people’s beliefs that they can control
Surveillance data show that young, acculturated Hispanic
women are more likely to get
Pap tests than those who are older and less acculturated.8 A
health department decides to
implement a cervical cancer screening program targeting older
Hispanic women. In
planning the campaign, practitioners want to conduct a survey
to learn what beliefs,
attitudes, and intentions in this population are associated with
seeking a Pap test. They
design the survey to gauge: when the women received their last
Pap test (behavior); how
likely they are to seek a Pap test (intention); attitudes about
getting a Pap test (attitude);
whether or not “most people who are important to me” would
want them to get a Pap
60. test (subjective norm); and whether or not getting a Pap test is
something that is “under
my control” (perceived behavioral control). The departme nt will
compare survey results
with data about who has or has not received a Pap test to
identify beliefs, attitudes, and
intentions that predict seeking one.
Figure 3. Theory of Reasoned Action and Theory of Planned
Behavior Figure 4. Stages of the Precaution Adoption Process
Model
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Note: Upper blue section shows the Theory
T
of Reasoned Action; the entire figure
Behavioral
beliefs
Evaluation of
behavioral outcomes
Attitude toward
behavior
Normative
beliefs
Motivation
to comply
63. Stage 5:
Decided
to Act
Stage 6:
Acting
Stage 4:
Decided
Not to Act
Stage 7:
Maintenance
18
shows the Theory of Planned Behavior.
Figure 3. shows the TPB’s explanation for
how behavioral intention determines
behavior, and how attitude toward behavior,
subjective norm, and perceived behavioral
control influence behavioral intention.
According to the model, attitudes toward
behavior are shaped by beliefs about what
is entailed in performing the behavior and
outcomes of the behavior. Beliefs about
social standards and motivation to comply
with those norms affect subjective norms.
The presence or lack of things that will
make it easier or harder to perform the
behavior affect perceived behavioral control.
Thus, a causal chain of beliefs, attitudes,
and intentions drives behavior.
64. Precaution Adoption Process Model
The Precaution Adoption Process Model
(PAPM) specifies seven distinct stages in
the journey from lack of awareness to
adoption and/or maintenance of a behavior.
It is a relatively new model that has been
applied to an increasing number of health
behaviors, including: osteoporosis
prevention, colorectal cancer screening,
mammography, hepatitis B vaccination,
and home testing for radon gas.
In the first stage of the PAPM, an individual
may be completely unaware of a hazard
(e.g., radon exposure, the link between
unprotected sex and HIV). The person may
subsequently become aware of the issue
but remain unengaged by it (Stage 2). Next,
the person faces a decision about acting
(Stage 3); may decide not to act (Stage 4),
or may decide to act (Stage 5). The stages
of action (Stage 6) and maintenance (Stage
7) follow. (See Figure 4.) According to the
PAPM, people pass through each stage of
precaution adoption without skipping any of
them. It is possible for people to move
backwards from some later stages to earlier
ones, but once they have completed the first
two stages of the model they do not return
to them. For example, a person does not
move from unawareness to awareness and
then back to unawareness.
The PAPM bears similarities to the Stages
65. of Change model, but differs in important
ways. Stages of Change offers insights for
addressing hard-to-change behaviors such
as smoking or overeating; it is less helpful
when dealing with hazards that have
recently been recognized or precautions
that are newly available. The PAPM
recognizes that people who are unaware of
an issue, or are unengaged by it, face
different barriers from those who have
decided not to act. The PAPM prompts
practitioners to develop intervention
strategies that take into account the stages
that precede active decision-making.
Interpersonal Level
At the interpersonal level, theories of health
behavior assume individuals exist within,
and are influenced by, a social environment.
The opinions, thoughts, behavior, advice,
and support of the people surrounding an
individual influence his or her feelings and
behavior, and the individual has a reciprocal
effect on those people. The social
environment includes family members,
coworkers, friends, health professionals,
and others. Because it affects behavior,
the social environment also impacts health.
Many theories focus at the interpersonal
level, but this monograph highlights Social
Cognitive Theory (SCT). SCT is one of the
most frequently used and robust health
behavior theories. It explores the reciprocal
interactions of people and their
environments, and the psychosocial
66. determinants of health behavior.
Social Cognitive Theory (SCT)
Social Cognitive Theory (SCT) describes a
dynamic, ongoing process in which personal
factors, environmental factors, and human
behavior exert influence upon each other.
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67. According to SCT, three main factors affect
the likelihood that a person will change a
health behavior: (1) self-efficacy, (2) goals,
and (3) outcome expectancies. If individuals
have a sense of personal agency or self-
efficacy, they can change behaviors even
when faced with obstacles. If they do not
feel that they can exercise control over their
health behavior, they are not motivated to
act, or to persist through challenges.9 As a
person adopts new behaviors, this causes
changes in both the environment and in the
person. Behavior is not simply a product of
the environment and the person, and
environment is not simply a product of the
person and behavior.
Table 5. Social Cognitive Theory
SCT evolved from research on Social
Learning Theory (SLT), which asserts
that people learn not only from their own
experiences, but by observing the actions
of others and the benefits of those actions.
Bandura updated SLT, adding the construct
of self-efficacy and renaming it SCT.
(Though SCT is the dominant version in
current practice, it is still sometimes called
SLT.) SCT integrates concepts and
68. processes from cognitive, behaviorist,
and emotional models of behavior change,
so it includes many constructs. (See Table
5.) It has been used successfully as the
underlying theory for behavior change
in areas ranging from dietary change10
to pain control.11
Reciprocal determinism describes
interactions between behavior, personal
factors, and environment, where each
influences the others. Behavioral capability
states that, to perform a behavior, a person
must know what to do and how to do it.
Expectations are the results an individual
anticipates from taking action. Bandura
considers self-efficacy the most important
personal factor in behavior change, and it
is a nearly ubiquitous construct in health
behavior theories. Strategies for increasing
self-efficacy include: setting incremental
goals (e.g., exercising for 10 minutes each
day); behavioral contracting (a formal
contract, with specified goals and rewards);
and monitoring and reinforcement (feedback
from self-monitoring or record keeping).
rather than through their own experience.
Reinforcements are responses to behavior
that affect whether or not one will repeat it.
Positive reinforcements (rewards) increase
a person’s likelihood of repeating the
behavior. Negative reinforcements may
make repeated behavior more likely by
motivating the person to eliminate a
69. negative stimulus (e.g., when drivers put the
key in the car’s ignition, the beeping alarm
reminds them to fasten their seatbelt).
Reinforcements can be internal or external.
Internal rewards are things people do to
reward themselves. External rewards (e.g.,
token incentives) encourage continued
participation in multiple-session programs,
but generally are not effective for sustaining
long-term change because they do not
bolster a person’s own desire or commitment
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Concept Definition Potential Change Strategies
71. Reciprocal
determinism
The dynamic interaction of the
person, behavior, and the
environment in which the
behavior is performed
Consider multiple ways to promote
behavior change, including making
adjustments to the environment or
influencing personal attitudes
Behavioral
capability
Knowledge and skill to perform
a given behavior
Promote mastery learning through
skills training
Expectations Anticipated outcomes of
a behavior
Model positive outcomes of
healthful behavior
Self-efficacy Confidence in one’s ability to
take action and overcome
barriers
Approach behavior change in small
steps to ensure success; be specific
about the desired change
72. Observational
learning (modeling)
Behavioral acquisition that
occurs by watching the actions
and outcomes of others’
behavior
Offer credible role models who
perform the targeted behavior
Reinforcements Responses to a person’s
behavior that increase or
decrease the likelihood
of reoccurrence
Promote self-initiated rewards
and incentives
Observational learning, or modeling, refers to change. Figure 5.
illustrates how self-
to the process whereby people learn efficacy, environmental,
and individual
through the experiences of credible others, factors impact
behavior.
Figure 5. An Intergrative Model
Behavioral beliefs
and their
evaluative aspects
Normative beliefs
and motivation
74. A university in a rural area develops a church-based
intervention to help congregation
members change their habits to meet cancer risk reduction
guidelines (behavior). Many
members of the church have low incomes, are overweight,
rarely exercise, eat foods that
are high in sugar and fat, and are uninsured (personal factors).
Because of their rural
location, they often must drive long distances to attend church,
visit health clinics, or
buy groceries (environment).
The program offers classes that teach healthy cooking and
exercise skills (behavioral
capability). Participants learn how eating a healthy diet and
exercising will benefit them
(expectations). Health advisors create contracts with
participants, setting incremental
goals (self-efficacy). Respected congregation members serve as
role models (observational
learning). Participants receive T-shirts, recipe books, and other
incentives, and are taught
to reward themselves by making time to relax (reinforcement).
As church members learn
about healthy lifestyles, they bring healthier foods to church,
reinforcing their healthy
habits (reciprocal determinism).
The conceptual frameworks in this section
offer strategies for intervening at the
community level:
• Community Organization and Other
Participatory Models emphasize
community-driven approaches to
assessing and solving health and
75. social problems.
• Diffusion of Innovations Theory addresses
how new ideas, products, and social
practices spread within an organization,
community, or society, or from one society
to another.
• Communication Theory describes how
different types of communication affect
health behavior.
Community Organization and Other
Participatory Models
Community organizing is a process through
which community groups are helped to
identify common problems, mobilize
resources, and develop and implement
strategies to reach collective goals. Strict
definitions of community organizing assume
that the community itself identifies the
problems to address (not an outside change
agent). Public health professionals often
adapt the methods of community organizing
to launch programs that reflect the priorities
of community members, but may not be
initiated by them. Community organizing
projects that start with the community’s
priorities, rather than an externally imposed
agenda, are more likely to succeed.
Community organizing is consistent with an
ecological perspective in that it recognizes
multiple levels of a health problem. It can be
integrated with SCT-based strategies that
take into account the dynamic between
76. personal factors, environmental factors,
and human behavior. Theories of social
networks and social support (exploring the
influence of social relationships on health
decision making and behavior) can be
used to adapt community organizing
strategies to health education goals.
Social systems theory (exploring how
organizations in a community interact with
each other and the outside world) is also
useful for this purpose.
Community organizing is not a single
mode of practice; it can involve different
approaches to effecting change. Jack
Rothman14 produced the best-known
classification of these change models,
describing community organizing according
to three general types: locality development,
social planning, and social action. These
models sometimes overlap and can
be combined.
• Locality development (or community
development) is process oriented. With the
aim of developing group identity and
cohesion, it focuses on building consensus
and capacity.
• Social planning is task oriented. It stresses
problem solving and usually relies heavily
on expert practitioners.
• Social action is both process and task
oriented. Its goals are to increase the
77. community’s capacity to solve problems
and to achieve concrete changes that
redress social injustices.
The different approaches broadly classified
as community organizing share in common
several concepts that are key to achieving
and measuring change. (See Table 6.)
Empowerment describes a social action
process through which individuals,
organizations, or communities gain
confidence and skills to improve their quality
of life.15 Community capacity refers to
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Initiatives serving communities and
populations, not just individuals, are at
the heart of public health approaches to
preventing and controlling disease.
Community-level models explore how
social systems function and change and
how to mobilize community members and
organizations. They offer strategies that
work in a variety of settings, such as health
care institutions, schools, worksites,
community groups, and government
agencies. Embodying an ecological
perspective, community-level models
address individual, group, institutional,
and community issues.
Communities are often understood in
geographical terms, but they can be defined
by other criteria too. For instance, there are
communities of shared interests (e.g., the
artists’ community) or collective identity
(e.g., the African American community).
When planning community-level
interventions, it is critical to learn about
the community’s unique characteristics.
This is particularly true when addressing
health issues in ethnically or culturally
diverse communities.
Comprehensive health promotion programs
often use advocacy techniques to help
80. support individual behavior change with
organizational and regulatory change. In
recent years, innovative tools and methods
for evaluation and measurement have been
developed to capture the successes of
community-level health promotion efforts.12 13
Tobacco control/smoking prevention is one
area where programs have been extensively
evaluated. Local tobacco control initiatives
typically pursue four concurrent goals: (1)
raising the priority of smoking as a health
concern, (2) helping community members to
change smoking behavior, (3) strengthening
legal and economic deterrents to smoking,
and (4) reinforcing social norms that
discourage smoking. This multi-level
approach has been proven very effective.
http:efforts.12
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Potential Change StrategiesTerm Definition
Community members assume
which people gain mastery over
Empowerment A social action process through
greater power, or expand their
their lives and their communities power from within, to create
desired changes
Community members participate Community Characteristics of
a community that
actively in community life, gaining
around, and address problems
capacity affect its ability to identify, mobilize
leadership skills, social networks,
and access to power
Community members develop
members as equal partners; reflects
82. Participation Engagement of community
leadership skills, knowledge, and
the principle, “Never do for others resources through their
what they can do for themselves” involvement
Community members create
where the people are”
Relevance Community organizing that ”starts
their own agenda based on felt
needs, shared power, and
awareness of resources
Community members participate
realizable targets for change that
Issue selection Identifying immediate, specific, and
in identifying issues; targets are
unify and build community strength chosen as part of a larger
strategy
Community members discuss the Critical Awareness of social,
political, and
root causes of problems and plan
social problems
consciousness economic forces that contribute to
actions to address them
Table 6. Community Organization
characteristics of a community that allow The social action
83. model differs from other
it to identify social problems and address forms of community
intervention in that it
them (e.g., trusting relationships between is grassroots based,
conflict oriented, and
neighbors, civic engagement). Participation geared to
mobilizing disadvantaged people
in the organizing process helps community to act on their own
behalf.16 Goals vary, but
members to gain leadership and problem- typically include
policy and other significant
solving skills. Relevance involves activating changes that
participants have identified as
participants to address issues that are important. Largely based
on the organizing
important to them. Issue selection entails work of Saul Alinsky
and the Industrial Areas
pulling apart a web of interrelated problems Foundation,17 this
approach employs direct-
into distinct, immediate, solvable pieces. action strategies as the
primary means of
Critical consciousness emphasizes helping fostering change. It
focuses on building
community members to identify the root power and encouraging
community
causes of social problems. members to develop their capacities
as active citizens.18
In a social action approach to community Media Advocacy is an
essential tactic in
organizing, self-interest is seen as the community organizing. It
involves using the
motivation for action: community members mass media
strategically to advance public
become involved when they see that it will policies.20 Because
84. the media bring attention
benefit them to take action, and targeted to specific issues, they
set the agenda for the
institutions are willing to make changes public and policy
makers. The media often
when they believe it is in their self-interest present health
information in medical terms,
to do so. Community organizing seeks to focusing on
technological breakthroughs and
expand participants’ sense of self-interest personal health
habits. Media advocacy
to an ever-wider sphere, from the assumes the root of most
health problems is
individual or family level to their block, not that people lack
information, but that they
neighborhood, city, state, and so on.19 lack the power to change
social and economic
Participants grow through this process, conditions. It seeks to
balance news coverage
learning to take an active role in shaping by framing issues to
emphasize social,
the future of their communities. economic, and political—rather
than personal
and behavioral—influences on health.21
Responding to high rates of cancer among African Americans, a
health department
wishes to increase consumption of fresh fruits and vegetables in
a low-income, urban
neighborhood. The department surveys community members to
find out why they do
not eat more fruits and vegetables. They learn there are few
supermarkets within easy
walking distance, and residents shop at local stores that do not
offer fresh, affordable
85. produce. Many do not own cars; they must take the bus, spend
money on taxis, or
carry shopping bags for blocks to shop at the supermarket.
The health department contacts a community-based organization
that has been working
to improve neighborhood conditions, and shares the findings
with them (participation).
The organization’s leaders invite department staff to attend a
community meeting,
where residents discuss why there are fewer supermarkets in
low-income neighborhoods
(critical consciousness). Residents say they would buy
healthier, less expensive foods at
the supermarket if they could get a ride home (relevance). The
community organization
decides to organize a campaign to convince the local
supermarket to start a shuttle
service (issue selection).
The health department trains residents to assess the potential
cost and ridership of the
shuttle service (community capacity). Residents plan an event
and invite the media.
They line up in front of the supermarket with shopping carts and
signs, and explain
both the problem and the potential solution to reporters (media
advocacy). Stories
appear in the local newspapers. The supermarket’s management
meets with community
residents and tells them the market loses thousands of dollars
each year due to stolen
shopping carts. Residents explain that the store will have fewer
shopping cart losses if
they start a shuttle (self-interest). The supermarket agrees to
give free rides to inner-city
86. shoppers. Through their success, residents gain skills and
confidence, and are inspired
to think about other ways to strengthen their community
(empowerment).
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http:citizens.18
http:behalf.16
In participatory action research, the people
who are being studied take an active role
in some or all phases of the research.
Participatory research builds an alliance
between professional researchers and
lay participants, and enables a dialogue
between them.22 When planning and
implementing health programs, the
program’s beneficiaries help to direct the
type of inquiry, collect and analyze data,
imagine possible solutions, and evaluate
the costs and benefits of each choice. They
engage in a learning process, both checking
and complementing expert knowledge. One
example of participatory action research is
the NCI’s COMMIT program, which explored
whether implementing an intervention
through community organizations would
result in a higher “quit rate” among heavy
smokers than in the comparison
communities.23 24
88. The CDC Task Force on the Guide to
Community and Preventive Services created
an organizing logic framework to illustrate
how community-level factors influence health
status. (See Figure 6.) They noted that
disparities in access to health care; behaviors
in response to illness; exposure to
environmental and occupational hazards;
health promotion and disease prevention
behaviors; and experience of stress, societal
support, and social cohesion all contribute
to disparities in health status. Therefore,
community-level interventions that address
population health until effective programs
are broadly diffused and disseminated.
Multiple critiques, including one by the
National Cancer Policy Board, suggest that
failing to implement proven methods of
cancer prevention and early detection
results in tens of thousands of premature
deaths each year.26 Diffusion expands the
number of people who are exposed to and
reached by successful interventions,
strengthening their public health impact.
Diffusion of Innovations Theory addresses
neighborhood conditions, employment how ideas, products, and
social practices
opportunities, behavioral norms, opportunities that are
perceived as “new” spread
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Figure 6. Sociocultural Environment Logic Framework
Guide to Community Preventive Services: Sociocultural
90. Environment Logic Framework
DETERMINANTS IMMEDIATE OUTCOMES HEALTH
OUTCOME
EQUITY and
SOCIAL JUSTICE
1* Neighborhood Living
Conditions
for education and training, and access to
health promotion, prevention, and care are
key to addressing health disparities.25 The
model shows elements and associations
at play in translating theory into research
and action.
throughout a society or from one society to
another. According to the late E.M. Rogers,
diffusion of innovations is “the process by
which an innovation is communicated
through certain channels over time among
the members of a social system.”27 Diffusion
Theory has been used to study the adoption
of a wide range of health behaviors and
programs, including condom use, smoking
cessation, and use of new tests and
technologies by health practitioners.
Table 7. defines concepts that are central
to this theory.
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SOCIETAL
RESOURCES
Standard of living
Culture and history
Social institutions
Built environments
Political structures
Economic systems
Technology
4
Community Development and
Employment Opportunities
2
92. 3 Civic Engagement and
Participation in
Decision-Making
Diffusion of Innovations
In public health and health promotion,
practitioners who want to make efficient use
of resources must attend to the reach,
adoption, implementation, and maintenance
of programs. It is not enough to develop
HEALTHIER
COMMUNITIES
innovative programs; to reduce the burden of
cancer, these programs must be disseminated Diffusion of
innovations that prevent disease
widely. Cancer control measures will not and promote health
requires a multilevel
realize their full potential for improving change process that
usually takes place in
Prevaling Community Norms,
Customs, and Processes
Opportunities for Education
and Developing Capacity
PHYSICAL
ENVIROMNMENT
Natural Resources
Table 7. Concepts in Diffusion of Innovations5
93. A pathway that will not be examined
HEALTHY
POPULATION
Concept
SOCIETAL RESOURCES
concerns the presence
of essential resources
Health Promotion, Prevention,
and Care Opportunities
Innovation6
while EQUITY and
SOCIAL JUSTICE
concerns the distribution Communication channels
*Links 1-6 indicate strategic
within the population
of those resources
points for intervention
Social system
Time
Source: Institute of Medicine. Speaking of Health: Assessing
Health Communications Strategies for Diverse
Populations. Washington, D.C.: National Academies Press,
94. 2002.
Definition
An idea, object, or practice that is thought to be new by an
individual, organization, or community
The means of transmitting the new idea from one person to
another
A group of individuals who together adopt the innovation
How long it takes to adopt the innovation
http:disparities.25
diverse settings, through different strategies.
At the individual level, adopting a health
behavior innovation usually involves lifestyle
change. At the organizational level, it may
entail starting programs, changing regulations,
or altering personnel roles. At a community
level, diffusion can include using the media,
advancing policies, or starting initiatives.
According to Rogers, a number of factors
determine how quickly, and to what extent,
an innovation will be adopted and diffused.
By considering the benefits of an innovation
(see Table 8.), practitioners can position it
effectively, thereby maximizing its appeal.
Specifically:
95. • The relative advantage of an innovation
shows its superiority over whatever
it replaces.
• Compatibility is an appropriate fit with the
intended audience.
• Complexity has to do with how easy it is
to implement the innovation.
• Trialability pertains to whether it can be
tried on an experimental basis.
• Observability reflects whether the
innovation will produce tangible results.
Effective diffusion requires practitioners to use
both informal and formal communications
channels and a spectrum of strategies for
different settings. Disseminating an innovation
in a variety of ways increases the likelihood
that it will be adopted and institutionalized.
Communication usually should include both
mass media and interpersonal interactions.
Through the two-step flow of communication,
information from the media moves in two
stages. First, opinion leaders, who pay
close attention to the media, receive the
information. Second, they convey their own
interpretations, as well as the media content,
to others. This process highlights the
value of social networks for influencing
adoption decisions.
Rogers described the process of adoption as
96. a classic “bell curve,” with five categories of
adopters: innovators, early adopters, early
majority adopters, late majority adopters, and
laggards. When an innovation is introduced,
the majority of people will either be early
majority adopters or late majority adopters;
fewer will be early adopters or laggards; and
very few will be innovators (the first people to
use the innovation). By identifying the
A university designs a program to help elementary school
children cultivate healthy
lifestyle habits and avoid chronic disease. The program has
many components: it
addresses the foods that children eat by modifying the fat and
sugar content of school
lunches, it teaches important health information through a
classroom-based health
education curriculum, and it encourages physical activity
through a physical education
component. It is highly successful; follow-up studies show that
children who went
through the program in elementary school continue to have
healthier habits in their
adolescence than those who did not go through the program.
The fact that the program is successful is not enough to ensure
it will change elementary
school practices. To achieve a broader impact, the program must
diffuse to other sites.
Program planners may seek to demonstrate the relative
advantage of the program by
emphasizing its positive outcomes. They may try to show its
compatibility by
demonstrating that state policy-makers (e.g., the state Board of
Education) have
97. approved its materials. The program’s complexity can be
limited by creating user-friendly
materials for teachers and cafeteria workers. By making the
materials available on a
Web site, they can enhance its trialability. Professional
demonstrations of the program
components can create an element of observability.
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characteristics of people in each adopter
category, practitioners can more effectively
plan and implement strategies that are
customized to their needs.
Communication Theory
99. Communication theory explores “who says
what, in which channels, to whom, and with
what effects.” It investigates how messages
are created, transmitted, received, and
assimilated. When applied to public health
Public health communications should
represent an ecological perspective and
foster multilevel strategies, such as tailored
messages at the individual level, targeted
messages at the group level, social marking
at the community level, media advocacy at
the policy level, and mass media campaigns
at the population level.29 Public health
communications can increase knowledge
and awareness of a health issue; influence
perceptions, beliefs, and attitudes that
Table 8. Key Attributes Affecting the Speed and Extent of an
Innovation’s Diffusion
Attribute
Relative advantage
Compatibility
Complexity
Trialability
Observability
Key Question
Is the innovation better than what it will replace?
100. Does the innovation fit with the intended audience?
Is the innovation easy to use?
Can the innovation be tried before making a decision to adopt?
Are the results of the innovation observable and easily
measurable?
problems, the central question theories of factor into social
norms; prompt action;
communication seek to answer is, “How do demonstrate or
illustrate healthy skills;
communication processes contribute to, or
discourage, behavior change?” Focused on
improving the health of communities rather
than examining the underlying processes of
communication, public health communications
is the scientific development, strategic
dissemination, and evaluation of relevant,
accurate, accessible, and understandable
health information, communicated to and
from intended audiences to advance the
public’s health.28
increase support for services; debunk
misconceptions; and strengthen
organizational relations.30 On the other
hand, without supports in the social and
physical environment, health communications
101. alone may not be enough to sustain
individual-level behavior changes, may
not be effective for relaying complex
health messages, and cannot compensate
for lack of access to health care or
healthy environments.31
http:environments.31
http:relations.30
http:health.28
http:level.29
30
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Since other communication strategies are
discussed elsewhere in this monograph, this
section examines the role of mass media in
public health interventions. The media are
interconnected, large-scale organizations
that gather, process, and disseminate news,
information, entertainment, and advertising
worldwide. Whether they are small
operations, such as a neighborhood
newspaper, or large corporations employing
tens of thousands of people, the media
influence almost every aspect of human life:
economic, political, social, and behavioral.
Media Effects
The outcomes of media dissemination of
ideas, images, themes, and stories are
termed media effects. Media effects research
investigates not only how the media influence
the knowledge, opinions, attitudes, and
behaviors of audience members, but also how
audience members affect the media. Because
audience members are active seekers and
users of health information, the content
transmitted through the media reflects their
needs, interests, and preferences. Two
questions are central to understanding the
effects of media on audience members: 1)
What factors affect the likelihood that a
person will be exposed to a given message?
2) How do media effects vary with the
amount of exposure to that message?32
103. Funding is a primary factor that determines
whether or not audience members will be
exposed to a message through the mass
media, since money is needed to buy media
time and space. Many public health programs
do not have large budgets, so they often must
rely on strategies for free distribution. Options
may include public service announcements,
embedding health messages in entertainment
programs (e.g., soap operas), or promoting
news coverage of public health topics in print
and electronic media. Community institutions
can adopt and disseminate messages, and
social networks can also generate excitement
about some messages, depending on
their content.33
How often do people need to hear a message
before it influences their beliefs or behaviors?
This depends on several factors.
Characteristics of target audiences (e.g.,
their readiness for change, the ways they
process information), the complexity of the
health issue, the presence of competing
messages, and the nature of the health
message influence the relationship between
exposure to a health message and an
outcome effect. Repeated exposure to a
message, especially when it is delivered
through multiple channels, may intensify
its impact on audience members.34
Planners often assume that a certain
percentage of the target audience will be
104. exposed to a message and that another
fraction of those who receive the message
will be engaged by it. Yet there are several
possible paths through which a health
communications message can influence
someone’s beliefs and/or behaviors. These
include immediate learning (people learn
directly from the message), delayed learning
(the impact of the message is not processed
until some time after it has been conveyed),
generalized learning (in addition to the
message itself, people are persuaded about
concepts related to the message), social
diffusion (messages stimulate discussion
among social groups, thereby affecting
beliefs), and institutional diffusion (messages
instigate a response from public institutions
that reinforces the message’s impact on the
target audience.)35
Agenda Setting
The mass media can illuminate and focus
attention on issues, helping to generate
public awareness and momentum for change.
A major focus of communications research
has been on how the mass media influence
public opinion, especially about politics and
policymaking. Agenda setting involves setting
the media agenda (what is covered), the
public agenda (what people think about), and
the policy agenda (regulatory or legislative
actions on issues).36 (See Table 9.) Research
on agenda setting has shown that the amount
of media coverage an issue receives
correlates strongly with the public’s opinion
105. of how important that issue is.
An axiom underlying this area of study is that
mass media may not tell us what to think, but
they are surprisingly effective in telling us
what to think about. A critical construct of
agenda setting, however, reinterprets this
idea. Framing is a process in which someone
tells the audience what aspect of the story is
important. In other words, they tell the
audience not only what to think about, but
how to think about it. The way facts are
packaged to tell a story creates the frame.
By framing stories to emphasize social and
environmental factors that affect health,
public health advocates can use the media
to pressure decision makers to develop
and support healthy policies.
New Communication Technologies
New communication technologies have
opened an extraordinary range of avenues
for influencing health behavior. “E-health”
(one element of new communication
technologies) is the use of emerging
information and communication technology,
especially the Internet, to improve or enable
31
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107. Problem definition
Framing
Definition
Institutional factors and
processes influencing how
the media define, select, and
emphasize issues
The link between issues
covered in the media and the
public’s priorities
The link between issues
covered in the media and
the legislative priorities of
policy makers
Factors and process leading to
the identification of an issue
as a “problem” by social
institutions
Selecting and emphasizing
certain aspects of a story and
excluding others
Potential Change Strategies
Understand media professionals’
needs and routines for gathering
and reporting news
108. Use media advocacy or
partnerships to raise public
awareness of key health issues
Advocate for media coverage to
educate and pressure policy
makers about changes to the
physical and social environment
needed to promote health
Community leaders, advocacy
groups, and organizations define
an issue for the media and
offer solutions
Advocacy groups “package” an
important health issue for the
media and the public
Table 9. Agenda Setting, Concepts, Definitions, and
Applications
http:issues).36
http:members.34
http:content.33
health and health care. The term refers to an
emerging field in the intersection of medical
informatics, public health, and business.37
It bridges clinical and non-clinical sectors,
and includes both individual and population
109. health-oriented tools.38 E-health
communication strategies include, but are
not limited to: health information on the
Internet, online support groups, online
collaborative communities, information
tailored by computer technologies,
educational computer games, computer-
controlled in-home telephone counseling,
and patient-provider e-mail contact.39
Major benefits of e-health strategies are
increased reach (the ability to communicate
to broad, geographically dispersed
audiences), asynchronous communication
(interaction not bounded by having to
communicate at the same time) the ability
to integrate multiple communication modes
and formats (e.g., audio, video, text,
graphics), the ability to track, preserve, and
analyze communication (computer records
of interaction, analysis of interaction trends),
user control of the communication system
(the ability to customize programs to user
specifications), and interactivity (e.g.,
increased capacity for feedback).40
Educational and behavioral interventions
Community organizing approaches have
been used to coordinate Internet-based
campaigns through www.Meetup.com
(a technology platform that helps people
self-organize local gatherings).
Innovative e-health projects are expanding
the range of tools that planners can use to
110. develop cancer control and other
interventions. For instance, NCI’s Cancer
Control Planet http://cancercontrolplanet.
cancer.gov/ links public health professionals to
comprehensive cancer control resources. NCI
also has published data from its Health
Information National Trends Survey (HINTS)
on the Web at http://cancercontrol.cancer.gov/
hints/. The HINTS program helps survey
researchers, program planners, and social
scientists understand how adults 18 years
and older are using different communication
channels, including the Internet. For example,
according to recent HINTS data, when asked
where they would go first if they had a strong
need to get information about cancer, 34
percent of respondents said they would go
to the Internet.
The HINTS data illustrate consumers’
increasing reliance on the Internet as an
easily accessible source of health information.
The Internet has been characterized as a
“hybrid technology” because it has the
potential to reach millions of people with
information that can be tailored to individual
needs and preferences.41 E-health
interventions frequently offer information,
education, and support directly to consumers.
For example, the Association of Online
Cancer Resources (ACOR), a collection of
online communities designed to provide timely
and accurate information in a supportive
environment, is one case in point. ACOR
delivers 1.8 million cancer messages each
week (http://www.acor.org/).
111. Not all e-health interventions are Web-based.
Computer applications have also allowed new
uses of traditional health communications
media, such as print and telephone. Tailored
print communications (TPCs) and telephone-
delivered interventions (TDIs) are two
examples that have the potential for reaching
linguistically and culturally diverse audiences.
TPCs are printed materials created especially
for an individual, based on relevant
information about that person. Over 40 studies
of TPCs have been conducted on a wide
range of health topics, including diet, exercise,
smoking cessation, mammography, and
prostate cancer; most have found positive
outcomes evidence. TDIs include a range
of human-delivered counseling and reminder
interventions delivered using the telephone
and computer-generated voice response
systems. Studies indicate that TDIs are
effective across different populations and
health topics, but do not have a broad-based
reach. They have not been widely used by
diverse populations.42
Interactive games offer another vehicle for
intervention. Lieberman et al. designed a
series of Nintendo video games to improve
children’s and adolescents’ prevention and
self care behaviors for asthma, diabetes,
smoking prevention, and other health topics
(see Figure 7.).43 The games were based
on well-established theories of learning and
behavior change, such as Social Cognitive
112. Theory. They reduced players’ urgent care
and emergency medical visits by as much
as 77 percent.44 Though research has
demonstrated the effectiveness of some
new communications technologies, further
inquiry is needed into the mechanisms’
underlying success.45
Opportunities are increasing for people to
gain free access to the Internet via libraries
and kiosks.46 Unequal access remains
problematic, however. Significant gaps in
Internet usage between Caucasians, African
Americans, and Hispanics persist,47 and
people with lower levels of educational
attainment are also less likely to have
Internet access. Because the Internet is
a text-based medium, literacy issues that
make it difficult for people to read print
materials are also barriers to accessing
Web-based information. There is danger
that new computer technologies could
worsen existing inequities in health status
for diverse populations. It is therefore
important to involve community members in
planning e-health interventions and to offer
them ongoing training and support for using
these emerging communications tools.48
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employing new communication technologies
are forging new ground and therefore benefit
from the perspective provided by theories
of health behavior. Like communications in
other media, e-health interventions can
address issues at the individual, group, or
community/societal level; different theories
may be appropriate, depending on the
project’s goals. For example, computer-
tailored print materials encouraging individuals
to eat more fruits and vegetables could be
designed using the Stages of Change Model.
Online support groups may apply theories of
social support and social networks.
Figure 7.
An Asthma Self-Management
Video Game for Children
117. Y
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Planning Models
When practitioners begin the process of
planning an intervention to promote health
or change health behavior, theory helps
them interpret the situation and guides their
decisions about what design, procedures,
and measurement indicators to select.
Depending on the unit of practice (e.g.,
individuals, groups, organizations,
community) and the nature of the health
problem, different theoretical approaches
may be appropriate. Practitioners can find
that using more than one theory to address
a problem produces a stronger impact.
This is particularly true when planning
comprehensive health promotion
programs that address multiple levels
(e.g., individual, organizational, community)
of a health problem.
118. Planning models, such as PRECEDE-
PROCEED and social marketing, help
practitioners develop programs step by step,
integrating multiple theories to explain and
address health problems. Practitioners
begin by using theory to develop a set of
assumptions about factors contributing to a
health problem. They then use research to
test, adjust, and add to these assumptions.
Armed with a theoretical framework and
situation-specific research findings,
practitioners design a targeted intervention
strategy. This includes designing an
evaluation to gauge whether or not the
approach is effective, and choosing realistic,
actionable goals that define in advance
what programmatic success will look like.
Research (into the needs of the population,
resources available, and the situation in
which the health problem occurs) is a
central feature of comprehensive planning
models. Theory helps planners think about
what questions to ask throughout program
planning, implementation, and evaluation
phases. During program planning, they
explore the needs and resources of the
population and learn how to design effective
materials and strategies. During
implementation, they seek to build and
continually improve the program. After it
ends, they assess what short-term and long-
term effects the program has had on the
health problem and its contributing factors.
119. Both social marketing and the PRECEDE-
PROCEED model instruct the practitioner
to begin the planning process by assessing
the target audience’s needs at multiple
levels of a health problem. In social
marketing, this preliminary investigation
involves conducting consumer research and
market analysis. In PRECEDE-PROCEED,
it includes carrying out epidemiological
assessment; behavioral, educational,
environmental, and organizational
diagnosis; and administrative and policy
assessment. Both planning models combine
behavior change theories for greater impact
and use them as a basis for evaluation.
These planning models are described in
greater detail in the sections that follow.
Social Marketing
Social marketing uses marketing techniques
to influence the voluntary behavior of target
audience members for health benefit. It
is distinct from health education in that it
goes beyond informing or persuading
people to reinforcing behavior with
incentives and other benefits. It also differs
from commercial marketing because the
people who gain from it are members of the
target audience. Another difference is that
the marketing organization defines success
in terms of positive effects on society.
Social marketing is not a theory, but an
approach to promoting health behavior.
Alan Andreason defines it as “the
120. application of commercial marketing
technologies to the analysis, planning,
execution, and evaluation of programs
designed to influence the voluntary behavior
of target audiences in order to improve their
personal welfare and that of society.”49
This process creates a voluntary exchange
between a marketing organization and
members of a target audience based on
mutual fulfillment of self-interest. In other
words, the marketing organization exists
to fulfill its mission (as defined by the
organization’s leadership), and the target
audience members act in their own interests.
Social marketing programs are generally
“consumer-driven,” not expert-driven. They
are targeted to serve a defined group of
people. To avoid delineating the target
market in an overly broad manner, social
marketing practitioners segment a larger,
heterogeneous target market into smaller
subgroups. Market segmentation is the
process of dividing a target audience into
these more homogenous subgroups with
distinct, unifying characteristics and needs.
For example, factors such as regional
location, ethnicity, gender, exercise habits,
readiness for change, or media habits could
be used to segment the larger audience
of “smokers.” Social marketing seeks to
identify patterns that distinguish one target
group from another to effectively target
marketing strategies.
121. The social marketing process involves
identifying an effective “marketing mix”
(“The four Ps”) of product, price, place,
and promotion. The optimal marketing mix
produces a timely exchange that heightens
benefits, reduces barriers, and offers a
better choice than the competition. The
social marketer explores what benefits
are of most interest to target market
members and develops strategies and
methods accordingly. The four Ps of the
marketing mix are:
• Product (the right kind of behavioral
change) includes not only the behavior
that is being promoted, but also the
benefits that go along with it.
• Price (an exchange of benefits and costs)
refers to barriers or costs involved in
adopting the behavior (e.g., money,
time, effort).
• Place (making new behaviors easy to do)
is about making the “product” accessible
and convenient. It means delivering
benefits in the right place at the right time.
• Promotion (delivering the message to the
audience) is how the practitioner notifies
the target market of the product, as well
as its benefits, reasonable cost,
and convenience.
Ideally, social marketing interventions begin