HW 425 Unit 6 SeminarTheory in Health Promotion & Education

Agenda

•Review requirements for final project•Discuss what a theory is and why theory

is important in designing and implementing health education & promotion programs

•Touch on commonly used theories•Address seminar discussion questions•Wrap-up

Final Project: Create your own health promotion program •You will decide to create a health

promotion program/intervention for a workplace or a community-based setting

•Need to decide a health issue upon which to focus

•Your final paper will be a mock (grant/funding) proposal detailing your program – think of the proposal as the document you would submit to a funder and/or your upper management for approval

Final Project: Create your own health promotion program (con’t.)•Review the additional instructions I’ve

posted – they offer an outline of the components to include in the paper.

•Review the sample website I share.•Review the course learning objectives.•Always think about how your paper

demonstrates your mastery of the complete planning process we covered in class.

•Have some fun . . . .

So, what is a theory?•Related concepts, definitions, & propositions•Presents a systematic view of something•Specifies the relationships between things

or ideas•Seek to explain or predict events or

situations•Important features:

▫Generality▫Testability▫Abstract

Some definitions of theory . . .• A set of interrelated constructs (concepts), definitions,

and propositions that present a systematic view of phenomena by specifying relations among the variables, with the purpose of explaining and predicting (Kerlinger, 1986)

• A systematic explanation for the observed facts and laws that relate to a particular aspect of life (Babbie, 1989)

• Knowledge writ large in the form of generalized abstractions applicable to a wide range of experiences (McGuire, 1983)

• A set of relatively abstract and general statements which collectively purport to explain some aspect of the empirical world (Chafetz, 1978)

• An abstract, symbolic representation of what is conceived to be a reality – a set of abstract statements designed to fit some portion of the real world (Zimbardo, Ebbesen, & Maslach, 1977)

Theory in health education and promotion•Divergence from the ideal •Useful during planning, implementing,

and evaluating interventions•Guide pursuit of answers to:

▫Why?▫What?▫How?

•Explain behavior to suggest ways to achieve change

Types of theories• Explanatory Theories (a.k.a. theory of the

problem)▫Describe and identify why problem exists▫Predict behaviors▫Guide search for modifiable factors (i.e.

knowledge, attitudes, self-efficacy, social support, access to resources)

• Change Theories (a.k.a. theories of action)▫Guide intervention▫Form basis of intervention – require explicit

assumptions about how programs work to cause change

•Implementation Theories▫ Are change theories that link theory to

specific audience, problem, context (IOM, 2002)

▫ Different foci, but complimentary

Types of theories continued

The health promotion field

•Vary in extent of conceptual development and empirical testing

•“theories are interpreted in different ways depending on the stage of the development of the field of study. In advanced disciplines, theories integrate laws; in less advanced fields theories specify the determinants governing the phenomena of interest.” (Bandura, 1986)

•Health promotion is a young field

Question . . . .

•When do we accept a new theory as truly advancing our understanding of a phenomena?

A few more important terms• Concepts, constructs, variables

▫ Concepts are the building blocks▫ Concepts developed or adopted for use in a specific

theory are called constructs Ex. Perceived susceptibility Health Belief Model

▫ Variables are empirical counterparts of constructs• Principles

▫ General guidelines for action▫ In the best form, supported by research, provide

the basis for hypothesis formation• Models

▫ Draw on a number of theories to help understand a specific problem in a particular setting or context [PRECEDE-PROCEDE]

Trends in commonly used Health Behavior Theories & Models•Health Belief Model (HBM)•Social Learning Theory•Social Cognitive Theory (SCT)•Theory of Reasoned Action•Theory of Planned Behavior•The Transtheoretical Model or Stages of

Change•Social Support/Networks•Social Marketing•Ecological Model

How are theories being used?

•In a review of theory use Glantz (2002) established levels of theory use▫Informed by theory (69.1%)▫Applied theory (17.9%)▫Tested theory (3.6%)▫Building/creating theory (9.4%)

Fitting theory to research or practice•Units of practice •Consider adequacy

▫Logic or internal consistency▫Parsimonious▫Plausibility

•Consider usefulness •Consider ecological validity

Discussion Question

•What are the benefits of using more than one theory in program planning?

Discussion Question

• What theories might be appropriate if one needs direction in working with an organization?

Highlights of Theories of Organizational Change•Change can occur at many levels in

organization•Four dimensions of organizational change

relevant to public health (McNamara, 2006)▫Organization-wide vs. subsystem▫Transformational vs. incremental▫Remedial vs. developmental▫Reactive vs. proactive

Relevant Organizational Theories and Models•Change within organizations

▫Stage theory of organizational change▫Organizational Development

•Change across organizations▫Interorganizational relations theory▫Community Coalition Action theory

•Applications in Health Promotion▫Promoting Heart Health in Nova Scotia

(OD theory)▫Rural Appalachian Cancer Coalitions

(CCAT)

Wrap Up

•Defined theory•Touched on common theories in health

promotion and education•Discussed seminar questions

•Questions?

Thank you & have a great night!

Mom’s Helper