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INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENTINSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
Theoretical approaches to researching environmental
influences on physical activity
Paul WattsInstitute of Health and Human
Development, University of East London
INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENTINSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
What do we mean by theory?
“A set of interrelated concepts, definitions, and propositions that presents a systematic view of events or situations by specifying relations among variables in order to explain and predict events or situations.”
(Glanz, et al., 1997)
INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENTINSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
Available Theories and Frameworks :
• Ecological Theories (McLeroy, 1988; Stokols, 1992)
• Urban Design Theories (e.g. Hamilton, 1999)• Intention / Attitude / Efficacy oriented theories
(e.g. Ajzen, 1991, Bandura, 1986).• Theoretical Frameworks (e.g. Swinburn et al.,
1999)
INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENTINSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
Achieving better predictive capacity through greater specificity.
The aesthetic environment and physical activity:Some examples of greater theoretical specificity:
‘Broken window theory’ (Wilson and Kelling, 1989).
Graffiti: Understanding specific social contexts.
‘Sightings of active people’: The role of cognitive mediation.
INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENTINSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
Broken Windows Theory Perception that ‘nobody cares’
A broken window is left unrepaired
Poor aesthetic environment
Dog mess not cleared
More broken windows
Litter is dropped
Fear of using streetsLower Physical
Activity
Social ConflictPerceived Danger
INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENTINSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
Why is it important to be so explicit?
Discourages ambiguity
Effective evaluation
Accept / Develop /Discard
Policy formulation
Specific contributions
Aggregation / integration of results
Influence behavior
INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENTINSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
Evaluating theoretical foundations of evidence
Applies Theory
Tests Theory
Informed by theory
Originates Theory
Develops Theory
Painter et al., (2008)
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INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
Systematic review - Preliminary Findings
010
20304050
60708090
100
Informed Applies Tests Develops
Num
ber
of S
tudi
es
98
27
137
First 150 studies analysed:
INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENTINSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
Findings cont.• Tendency to reference theory followed by
a ‘pick and choose’ approach to construct selection.
• Failure to operationalize theoretical constructs into measurable constructs - i.e. Not measuring what they claim to be e.g. social capital.
• Measures of physical activity often didn’t reflect the theory that informed the study.
• No discussion of the role of cognitive mediation.
INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENTINSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
Conclusions and Recommendations• Turn ‘accepted wisdom’ into explicit theory (Allender et al, 2009).• Don’t simply reference theory; link the theory to the measure and EXPLICATE.• Choose appropriately from the range of theory available.• Make theories more accessible and user friendly.• A beacon for public health theory.• Seize opportunities to test theories.
INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENTINSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
Recommended Reading• Glanz, K., Lewis, F.M. and Rimer, B.K. (2002 ) Linking theory, research and practice. In Glanz, K., Lewis, F.M. and Rimer, B.K.
(eds), Health Behavior and Health Education: Theory, Research and Practice, 2nd edn. Jossey-Bass, San Francisco, CA, pp. 19–35.
• Bedimo-Rung, A. L., Mowen, A. J., Cohen, D. A. (2005) The Significance of Parks to Physical Activity and Public Health A Conceptual Model. Am J Prev Med 2005;28(2S2):159 –168
• Handy, Al., Boarnet, M.G., Ewing, R. et al., (2002) How the Built Environment Affects Physical Activity: Views from Urban Planning. Am J Prev Med 23(2S):64 –73
• Kremers, SPJ., de Bruijn, G., Visscher T et al., (2006). Environmental influences on energy balance-related behaviors: A dual-process view. International Journal of Behavioral Nutrition and Physical Activity, 3: 9
• www.activelivingresearch.org – Research Archive, Tools Archive, News links etc.
• February 2009 supplement to the Journal of Public Health Policy.
INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENTINSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
Acknowledgements• Thank you to:
• Prof Mark Petticrew (LSHTM)
• Prof Adrian Renton (IHHD, UEL)
• Dr Rachel Aldred (UEL)
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INSTITUTE FOR HEALTH AND HUMAN DEVELOPMENT
References Ajzen,I. (1991). The theory of planned behaviour. Organisational Behaviour and
Human Decision Processes, 50, 179–211. Allender, S., Cavill, N., Parker, M., Foster, C., (2009) `Tell us something we don't
already know or do!' — The response of planning and transport professionals to public health guidance on the built environment and physical activity. Journal of Public Health Policy, Volume 30, Number 1, April 2009 , pp. 102-116(15)
Bandura A. (1986). Social foundations of thought and action. Englewood Cliffs, NJ: Prentice-Hall,
Glanz, K., Lewis, F.M. and Rimer, B.K. (1997) Linking theory, research and practice. In Glanz, K., Lewis, F.M. and Rimer, B.K. (eds), Health Behavior and Health Education: Theory, Research and Practice, 2nd edn. Jossey-Bass, San Francisco, CA, pp. 19–35.
McLeroy, K., D. Bibeau, A. Steckler, and K. Glanz (1988). An ecological perspective on health promotion programs. Health Educ. Q. 15:351–377.#
Painter, J. E., Borba, C. P., Hynes, M., Mays, D., & Glanz, K. (2008). The use of theory in health behaviour research from 2000 to 2005: a systematic review. Annals of Behavioral Medicine, 35(3), 358–362.
Stokols D. (1992). Establishing and maintaining healthy environments: towards a social ecology of health promotion. Am Psychol;47:6–22.
Swinburn B, Egger G, Raza F (1999). Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental 60 interventions for obesity. Prev Med;29:563–70.
Wilson JQ, Kelling GL. Broken windows. In: Dunham RG, Alpert GP, eds. Critical Issues in Policing: Contemporary Readings. Prospect Heights, Ill: Waveland Press Inc; 1989.