hbhe600 2008 01 intro measurement
TRANSCRIPT
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UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
HBHE 600: PsychosocialFactors in Health-Related Behavior
Victor J. Strecher, PhD
Professor, HBHE
School of Public Health
University of Michigan
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Introduction Course Syllabus
Description
Objectives
Flow
Readings
Grading
Academic conduct
Diversity issues
Why were here
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HBHE 600 provides an overview of the
social-psychological determinants of
behavioral risk factors that affect health.
We address these determinants within
conceptual frameworks and models of
health-related behavior. These
determinants are the building blocks of
intervention and program planning.
HBHE 600 DESCRIPTION
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HBHE 600 OBJECTIVES
By the end of the course, participants
should have a general understanding of:
1. THE MAJOR PSYCHOSOCIAL MODELS AND THEORIES USED
IN THE FIELD OF HEALTH BEHAVIOR AND HEALTH
EDUCATION
2. THE ROLE OF PSYCHOSOCIAL FACTORS IN PREDICTING A
RANGE OF HEALTH-RELATED BEHAVIORS
3. USING PSYCHOSOCIAL MODELS AND DETERMINANTS TO
DEVELOP A CONCEPTUAL FRAMEWORK OF HEALTH
BEHAVIOR CHANGE
4. INTERVENTIONS TO CHANGE PSYCHOSOCIAL
DETERMINANTS
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HBHE 600 FLOWTheory
Determining andmeasuring relevant
psychosocial factors
Health Belief Model
Theory of Reasoned Action
Theory of Planned Behavior
Social Cognitive Theory
Transtheoretical Model
Self-Determination Theory
Chaos Theory
Motivational Interviewing
Behavior Modification
Goal TheorySocial Support
Elaboration Likelihood Model
Cognitive Load Theory
Cognitive Schema
Building conceptual
frameworks for health-
related behavior.
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HBHE 600 READINGS
In HBHE 600 CourseTools
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Mid-term exam (40%)
Final exam (60%)
HBHE 600 GRADING
Content of the examinations will come from
class lectures and the required readings.
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HBHE 600 ACADEMIC CONDUCT
Students should expect faculty and
graduate assistants to treat them fairly,
showing respect for their ideas and
opinions and striving to help them achieve
maximum benefits from their experience
in the School of Public Health.
Similarly, courtesy, honesty, and respect
should be shown by students towardfaculty, graduate assistants, and fellow
students.
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HBHE 600 ACADEMIC CONDUCT
Student academic misconduct refers to
behavior that may include plagiarism,
cheating, fabrication, falsification of
records or official documents, and aidingand abetting the perpetration of such
acts. Preparation of the mid-term and
final examinations must represent each
students own effort.
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HBHE 600 DIVERSITY ISSUES
Language
Culture
Background1st /2nd /3rd generation college?
Comfortable speaking up, asking questions?
Is class a comfort zone or an alien environment?
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Heart disease
Cancer
Cerebrovasc. disease
Unintentional injuries
Chronic lung disease
Pneumonia/ Influenza
Diabetes
Suicide
Chronic liver diseaseHIV infection
720,058
505,322
144,088
91,98386,679
79,513
47,664
30,90625,188
1,757,188
Cause Estimated #
Deaths
10 leading causes of death in the United States
McGinnis JM, Foege WH. Actual causes of death in the United States. JAMA. Vol 270, #18, 1993.
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400,000
300,000
100,00090,000
60,000
35,000
30,000
25,000
20,000
1,060,000
19
14
54
3
2
1
1
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10 Priorities of Nations 2010 Objectives
Physical activity Overweight and obesity
Tobacco use
Substance abuse
Responsible sexual
behavior
Mental health Injury and violence
Environmental quality
Immunization
Access to health care
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"Even our most conservative estimate indicates that reductions in lung
cancer, resulting from reductions in tobacco smoking over the last halfcentury, account for about 40% of the decrease in overall male cancer
death rates and have prevented at least 146 000 lung cancer deaths in
men during the period 1991 to 2003. A more realistic straight line
projection of what lung cancer rates might have become suggests that,
without reductions in smoking, there would have been virtually no
reduction in overall cancer mortality in either men or women sincethe early 1990s. The payoff from past investments in tobacco controlhas only just begun. The aging of birth cohorts with lower smokinginitiation rates and the anticipated future decrease in lung cancer
mortality in women will help to sustain progress."
Michael Thun, American Cancer Society
Tobacco Control
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(*BMI 30, or ~ 30 lbs. overweight for 5 4 person)
Obesity Trends* Among U.S. AdultsBRFSS, 1985
No Data
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(*BMI 30, or ~ 30 lbs. overweight for 5 4 person)
Obesity Trends* Among U.S. AdultsBRFSS, 1986
No Data
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(*BMI 30, or ~ 30 lbs. overweight for 5 4 person)
Obesity Trends* Among U.S. AdultsBRFSS, 1987
No Data
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(*BMI 30, or ~ 30 lbs. overweight for 5 4 person)
Obesity Trends* Among U.S. AdultsBRFSS, 1988
No Data
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(*BMI 30, or ~ 30 lbs. overweight for 5 4 person)
Obesity Trends* Among U.S. AdultsBRFSS, 1989
No Data
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(*BMI 30, or ~ 30 lbs. overweight for 5 4 person)
Obesity Trends* Among U.S. AdultsBRFSS, 1990
No Data
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(*BMI 30, or ~ 30 lbs. overweight for 5 4 person)
Obesity Trends* Among U.S. AdultsBRFSS, 1992
No Data
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UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
(*BMI 30, or ~ 30 lbs. overweight for 5 4 person)
Obesity Trends* Among U.S. AdultsBRFSS, 1993
No Data
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(*BMI 30, or ~ 30 lbs. overweight for 5 4 person)
Obesity Trends* Among U.S. AdultsBRFSS, 1995
No Data
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UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
(*BMI 30, or ~ 30 lbs. overweight for 5 4 person)
Obesity Trends* Among U.S. AdultsBRFSS, 1996
No Data
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UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
(*BMI 30, or ~ 30 lbs. overweight for 5 4 person)
Obesity Trends* Among U.S. AdultsBRFSS, 1997
No Data
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UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
(*BMI 30, or ~ 30 lbs. overweight for 5 4 person)
Obesity Trends* Among U.S. AdultsBRFSS, 1998
No Data
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UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
(*BMI 30, or ~ 30 lbs. overweight for 5 4 person)
Obesity Trends* Among U.S. AdultsBRFSS, 1999
No Data
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UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
(*BMI 30, or ~ 30 lbs. overweight for 5 4 person)
Obesity Trends* Among U.S. AdultsBRFSS, 2000
No Data
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UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
(*BMI 30, or ~ 30 lbs. overweight for 5 4 person)
Obesity Trends* Among U.S. AdultsBRFSS, 2001
No Data
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UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
(*BMI 30, or ~ 30 lbs. overweight for 5 4 person)
Obesity Trends* Among U.S. AdultsBRFSS, 2002
No Data
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UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
(*BMI 30, or ~ 30 lbs. overweight for 5 4 person)
Obesity Trends* Among U.S. AdultsBRFSS, 2003
No Data
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UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
(*BMI 30, or ~ 30 lbs. overweight for 5 4 person)
Obesity Trends* Among U.S. AdultsBRFSS, 2004
No Data
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UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
(*BMI 30, or ~ 30 lbs. overweight for 5 4 person)
Obesity Trends* Among U.S. AdultsBRFSS, 2005
No Data
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Ecological Perspectives on Health
Promotion
Examine the joint or cumulative effects of personaland environmental factors in designing health
promotion programs.
Take into account linkages between various settingsand levels, and how change at one level affects
others.
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Individual vs. Social Responsibility
No one would question that, as individuals, we are responsible for
our health. In the final analysis, we are the only ones who canchange our behavior. We are the only ones who lift fork to mouth,
who inhale smoke, who plant feet on sidewalk. And we are the
only ones who can decide to do these things[But] we dont live ina vacuum. Whether we like it or not, our thoughts, ideas, wishes
and behaviors are influenced and conditioned by the people aroundus, by the environments in which we find ourselves, and by the
customs, traditions, fads and fashions to which we are continuously
exposedEffective behavior change therefore requires that we do
our best as individuals, but also that we work together with one
another to create more healthful and supportive socialenvironments.
S. Leonard Syme
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Theories
Determining and
measuring
psychosocial
constructs in
theories
Wh t i th ?
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Definitions
Characteristics
Concepts, Constructs, and Variables
What is a theory?
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Definitions of Theory
A set of interrelated constructs, definitions, and propositionsthat presents a systematic view of phenomena by specifyingrelations among variables, with the purpose of explaining andpredicting phenomena. (Kerlinger, 1986, p. 9)
A systematic explanation for the observed facts and laws that
relate to a particular aspect of life. (Babbie, 1989, p. 46)
An abstract, symbolic representation of what is conceived tobe realitya set of abstract statements designed to fit someportion of the real world. (Zimbardo, Ebbesen, & Maslach,1977, p. 5)
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General - broad application
Abstract - not specified in detail
Testable - you can measure constructs
Replicable - can be tested again and again
Characteristics of Theory
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UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Concepts - major components or ideas of a theory
Constructs - when concepts have been developed for
use in a particular theory, they are called constructs.
Variables - are the operational form of constructs.
They specify how a construct is to be measured in a
specific situation.
Concepts, constructs, and variables
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UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Theories can tell you
WHY people are or are not engaging in health-related behaviors.
WHAT needs to be evaluated to demonstrateprogram or policy effectiveness.
HOW to shape program strategies to reach peopleand organizations.*
*Though most psychosocial theories of health-relatedbehavior dont do this.
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How do we create, examine, test theories?
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Surveying
Observing
From: OLeary, Z. (2004) The Essential Guide to Doing Research. London: Sage Chapter Eleven.
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Survey
Survey (noun): Information gathered by askinga range of individuals the same questionsrelated to their characteristics, attributes,how they live, or their opinions
Survey (verb): The process ofcollecting such
information
From: OLeary, Z. (2004) The Essential Guide to Doing Research. London: Sage Chapter Eleven.
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Basic Survey Types
Surveys can also involve populations or samples of
populations:
Census: This is a survey that does not rely on a
sample. A census surveys every single person ina defined or target population
Cross-sectional surveys: This type of survey
uses a sample or cross-section of respondentsselected to represent a target population
From: OLeary, Z. (2004) The Essential Guide to Doing Research. London: Sage Chapter Eleven.
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Basic Survey Types
Surveys can capture a moment or map trends:
Trend surveys: A trend survey asks similar groupsof respondents, or the same cross-section, the
same questions at two or more points in time
Panel study: A panel study involves asking thesame (not similar) sample of respondents the same
questions at two or more points in time
From: OLeary, Z. (2004) The Essential Guide to Doing Research. London: Sage Chapter Eleven.
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Basic Survey Types
Surveys can be administered in lots of ways:
Face to face
Telephone
Self-administered
Now the Web!
From: OLeary, Z. (2004) The Essential Guide to Doing Research. London: Sage Chapter Eleven.
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Interview Types
Interviews can range from fixed to free: Structured: Uses pre-established questions, asked in a
predetermined order, using a standard mode of delivery
Semi-structured: As the name suggests, these interviews
are neither fully fixed nor fully free, and are perhaps bestseen as flexible
Unstructured:Attempts to draw out information,attitudes, opinions, and beliefs around particular themes,
ideas, and issues without the aid of predeterminedquestions
From: OLeary, Z. (2004) The Essential Guide to Doing Research. London: Sage Chapter Eleven.
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Self-efficacy Example:
When I feel stressed
After I have just finished a meal
While drinking coffee with friends
When I feel sad or lonely
While talking on the telephone
When I am around people who are smoking
When I feel angry or frustrated
When I am happy and feel like celebrating
While driving
When I feel nervous or anxious
When I am bored
When at a bar or a party
Please rate how confident you are that you can keep from smoking cigarettes in the following situations:
Not at allconfident
Extremelyconfident
1 2 3 4 5
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
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UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Motives
The medication is good for my diabetes. I feel guilty if I dont take my meds.
Its an important choice that I make for myself.
Ive seen what diabetes has done for others.
I like the challenge of taking responsibility for my health. My family and/or friends get upset with me if I dont take my meds.
I want to be in charge of my diabetes.
My physician gets upset with me if I dont take my meds.
It is consistent with my goals of taking control of my diabetes. I can avoid or delay getting other health problems if I take my meds.
I want to set a good example for others.
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UNIVERSITY OF MICHIGAN SCHOOL OF PUBLIC HEALTH
Motives
The medication is good for my diabetes. I feel guilty if I dont take my meds.
Its an important choice that I make for myself.
Ive seen what diabetes has done for others.
I like the challenge of taking responsibility for my health. My family and/or friends get upset with me if I dont take my meds.
I want to be in charge of my diabetes.
My physician gets upset with me if I dont take my meds.
It is consistent with my goals of taking control of my diabetes. I can avoid or delay getting other health problems if I take my meds.
I want to set a good example for others.
Intrinsic Extrinsic
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Validity of self-reported data:
In some cases validity varies by demographiccharacteristics
More important are:
Surroundings
Person or thing asking the question
How the question is asked
The questions preceding the question
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Surveying
Observing
From: OLeary, Z. (2004) The Essential Guide to Doing Research. London: Sage Chapter Eleven.
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Types of Observation Observational techniques can range from highly
structured to unstructured.
Structured: Highly systematic and often rely on predeterminedcriteria related to the people, events, practices, issues, behaviors,actions, situations, and phenomena being observed.
Semi-structured: Observers generally use some manner ofobservation schedule or checklist to organize observations, but alsoattempt to observe and record the unplanned and/or the unexpected.
Unstructured:Observers attempt to observe and record data without
predetermined criteria.
F OL Z (2004) Th E i l G id D i R h L d S Ch El