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1
Q

The Major Social Determinants of Health

A

Social gradient, stress, early life, social exclusion, work, unemployment, social support, addiction, food, transportation

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2
Q

how to properly select a theory(5)

A

oDevelop problem statement
oIdentify target behavior
oConduct a functional assessment
oSelect a theory
oDevelop a theory based intervention

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3
Q

What is vicarious learning and where did it originate?

A

oOriginated from Albert Bandura – Bobo doll experiment
- learning things from observing others

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4
Q

What did basic research of children and BOBO dolls teach Albert Bandura?

A

oObservational learning
oImitation/modeling – imitated behaviors observed by adults
oGeneralization of aggression – demonstrated new aggression that wasn’t modeled
oRole of reinforcement – more likely to imitate if they witnesses adult being rewarded for actions rather than punished
oVicarious consequences – individuals learn by observing the consequences of others
oSocial cognitive theory – cognitive processes, behavior, environment
oEthical – impact of observing aggressive behavior on children

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5
Q

Be familiar with the various levels of the ecological model

A

oIntrapersonal – factors that are specific to individuals’ personal characteristics
oInterpersonal – influences within individuals’ immediate social environment
oOrganizational – within larger organizations and institutions that shape individuals’ health and behavior – work, community groups
oCommunity – broader influence – neighborhoods, communities
oPolicy – laws, regulations, societal cultural norms that shape behaviors at population level

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6
Q

Understand the difference between topography and function.

A

oTopography: how the behavior looks
oFunction: the purpose of the behavior

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7
Q

What is reciprocal determinism?

A

The interaction and influence between personal factors, behavior, and environment

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8
Q

What is the difference between the theory of reasoned action and the theory of planned behavior?

A

TPB – includes the added component of perceived behavioral control

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9
Q

Understand the different types of social capital and examples of each

A

Bridging
Bonding

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10
Q

Be familiar with the definition of social capital and how we might measure it

A

Assessing resources and connections available to individuals or groups within a social network

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11
Q

Define and recognize self-efficacy

A

the confidence in oneself and the belief in one’s ability to accomplish specific tasks or engage in health-related behaviors

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12
Q

Identify processes for increasing self-efficacy

A

-Mastery experience – firsthand success in task or skill development
-Vicarious experience – learning through other people
-Verbal persuasion – words and communication to influence others – social support and encouragement
-Managing somatic and emotional states – regulating and controlling the physical and emotional aspect of well-being

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13
Q

What is self-efficacy?

A

Confidence in oneself, specifically confidence in ability to engage in health-related behaviors

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14
Q

Who pioneered self efficacy theory?

A

Albert Bandura

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15
Q

What is the main focus of the model of self efficacy?

A

Cognitive determinants of behavior

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16
Q

What was learned from Bandura’s BOBO doll experiment?

A

Humans are capable of learning new behaviors vicariously

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17
Q

What are the 4 Strategies to increase Self-Efficacy (constructs)?

A

oVicarious experience – learning from observing others to be successful performing the behavior
oMastery experience – performing the behavior yourself and being successful
oVerbal persuasion – social support or encouragement
oMinimizing somatic and emotional states – when we try to influence people’s self-efficacy under conditions where they are highly emotionally energized or charged, we’re not successful

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18
Q

who pioneered the social cognitive theory

A

Albert Bandura

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19
Q

What is Social Cognitive Theory?

A

A middle ground between the psychological determinants of behavior and the environmental determinants of behavior. Both ideas are important in changing behavior

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20
Q

What is the main focus of the model? (social cognitive theory)

A

Cognitive determinants of behavior

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21
Q

What is the triadic model of reciprocal determinism? *What are the three components?

A

*Personal factors – characteristics, processes, beliefs
*Environmental factors – external influences which individuals operate
*Behavior – of individual

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22
Q

What is the difference between a tenant and a construct?

A

*Tenants – foundation of the theory, the proof the theory works
*Constructs are the framework on top of the foundation – the things that interventionists try to change in order to change behavior

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23
Q

What are the constructs included in this theory? (social cognitive theory)- 7

A

*Knowledge – information individuals possess about environment, consequences, which influence decision making
*Situational perception – individuals’ interpretation and understanding of current context, influences likelihood of engaging behavior based on assessment of situation
*Outcome expectation – individuals’ anticipation of consequences or results of specific behavior, influencing motivation and decision to engage in that behavior
*Outcome expectancies – overall set of anticipated consequences, both positive and negative, associated with behavior, shaping preferences, choices, and persistence in that behavior
*Environment – surroundings and external influences that shape behavior
*Self-efficacy – individuals’ belief in their capability to successfully perform task or behavior, influencing motivation
*Reinforcement – consequences that follow behavior and influence likelihood of behavior being repeated

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24
Q

What is the purpose behind this theory? - TRA/ TPB

A

Behavior is driven by intention to behave, which are influenced by attitudes and subjective norms

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25
What is the main focus of this model? - TRA/TPBRA
Cognitive determinants of behavior
26
What is the difference between the TPB and the TRA?
TPB – includes the added component of perceived behavioral control
27
Who pioneered the TRA?
Martin Fishbein and Icek Azjen
28
What are the constructs included in the TPB- 10
*Intention – planned or anticipated course of action – readiness to commit to behavior *Attitudes – overall evaluation or feeling of preference toward behavior *Behavioral beliefs – expectations regarding consequences or outcomes associated with behavior *Outcome evaluation – assessing value of outcome or consequences with the behavior *Subjective norms – individuals’ belief regarding attitude and opinion of significant others in life *Normative beliefs – perceptions or thoughts person has about how significant others would prefer them to behave *Motivation to comply – individuals’ willingness to conform to preference of others *Perceived behavioral control – extent of control individuals perceive they have over behavior *Perceived power – perception of ease or difficulty of behavior *Control beliefs – belief about internal and external factors that have potential to inhibit or facilitate performance of behavior
29
What are the origins of the model? - Health Belief Model
Investigations into why people were signing up for free tuberculosis screenings in the 1950’s
30
What is the main focus of this model? - Health Belief Model
Cognitive determinants of behavior
31
What does the health belief model try to understand?
People’s perceptions about health outcomes and how that relates to them engaging in health-related behaviors
32
What are the constructs that make up the model? - Health Belief Model- 7
*Perceived susceptibility – belief regarding likelihood of reaching harmful state in specific behavior *Perceived severity – belief about the extent of harm that can come from specific behavior *Perceived benefits – belief in advantages of specific behavior *Perceived barriers – belief about obstacles associated with adopting new behavior *Modifying variables – influences – external factor that my influence how the constructs interact *Cues to action – forces that prompt individual to feel the need to act *Self-efficacy - individuals’ belief in their capability to successfully perform task or behavior, influencing motivation
33
What are the origins of the model? Who developed it? - Transtheoretical Model
James Prochaska – prominent researcher in the area of substance abuse was one of the first individuals to use the model
34
What is another commonly known name for the model?transtheoretical model
The stages of change model
35
What is the main focus of this model? - transtheoretical model
Cognitive determinants of behavior
36
What does the transtheoretical model suggest?
Behavior change is a continuum, not a discrete event
37
What are the Stages of Change?
Precontemplation, contemplation, preparation, action, and maintenance
38
At the early stages of change, which are most noticeable, pros or cons?
The cons
39
During what stage is Consciousness raising most important?
Precontemplation, contemplation stages
40
What are the Processes of Change?7
* Consciousness raising – experiential process – elevate awareness regarding cause, consequence, potential solution for problem * Dramatic belief – intensify emotional arousal about behavior, highlight relief that can result from making a change – emotional response to show need for change: contemplation * Self- re-evaluation – individuals’ assessment of their self-image in relation to a new behavior: contemplation * Environmental re -evaluation – how a behavior impacts one’s environment and how changing that behavior would influence the surroundings – broader consequences of actions: contemplation and preparation * Counterconditioning – learning new behavior to replace existing unhealthy behavior: preparation and action * Contingency management – using reinforcement and punishment to encourage or discourage behaviors: action and maintenance * Stimulus control – modifying environment to enhance cues for healthy behavior while diminishing cues for unhealthy behavior: action and maintenance
41
Why are these methods sometimes neglected from behavior change interventions? - Applied Behavior Analysis
Because interventionists often hope people will change behavior solely because they want to change, not because of an external reward, which is usually not the case
42
What is the main focus of this model? - Applied Behavior Analysis
Environmental determinants of behavior
43
What is the definition of topography?
How the behavior looks
44
What is the definition of function?
The purpose of the behavior
45
What are the ”constructs” of this theory? - applied behavior analysis
Behaviors exist because they serve a purpose new behaviors that serve a purpose can be developed easily practice is important in developing new behaviors coercion interferes with learning and uptake of new behaviors
46
What is the 3-term contingency? What is a contingency in general?
*Behaviors broken into 3 parts – stimulus, operant response, and reinforcer/punishment *Contingency – term used to describe the relationship between behavioral antecedents, behavioral occurrences, and the consequences that follow
47
What is the origins of this model? - ecological model
It was first put forth by Bronfenbrenner and modernized by James Sallis
48
What does this model suggest? - ecological model
Behavior is affected by multiple levels of influence and different levels in the environment each play an important role in health behaviors
49
What is the main focus of this model? - ecological model
Environmental determinants of behavior
50
What are the levels in this model? - ecological model
* Intrapersonal – factors that are specific to individuals’ personal characteristics * Interpersonal – influences within individuals’ immediate social environment * Organizational – within larger organizations and institutions that shape individuals’ health and behavior – work, community groups * Community – broader influence – neighborhoods, communities * Policy – laws, regulations, societal cultural norms that shape behaviors at population level
51
What was learned from the reading about the impacts of retailer proximity?
Adolescent substance use is influenced by the proximity of retailers
52
What is the difference between the Behavioral Ecological Model and the traditional Ecological Model?
BEM includes concepts from applied behavioral analysis
53
What is the main focus of the behavioral ecological model?
Environmental determinants of behavior
54
Define hierarchical or cascading contingency
Sequential and interconnected series of events that unfold in response to specific behavioral adaptions
55
What is the best example of the BEM in practice?
The California tobacco control program
56
What are the levels of the BEM? 4
Individual – factors inherent to an individual Local network – perceptions, belief, attitude shared among individuals within specific social units Community – beliefs within broader social unit of community Society – highest level of social organization – multiple communities or groups
57
Who is the pioneer for the social determinants of health theory?
Sir Michael Marmot
58
Sir Michael Marmot calls the Social Determinants of Health “the causes of the causes.” What does this mean?
The social determinants themselves don’t cause illness; they cause the conditions which cause illness
59
What does this theory suggest? social determinants of health
Wealthier individuals fare better, and poorer individuals suffer more in health related areas. Why? Because access to health care and education is limited as a person moves down the social gradient and conditions of work, leisure, home environment, ect. are all better the higher up a person is on the social gradient
60
What are the prominent social determinants?
Social gradient, stress, early life, social exclusion, work, unemployment, social support, addiction, food, transportation
61
T/F, the deterioration in health seen in industrialized world is because of genetics?
FALSE
62
According to Sir Michael Marmot, is health more related to absolute or relative wealth?
Relative Wealth
63
Are citizens of wealthier countries always healthier of citizens of less wealthy countries?
No
64
Define social gradient
the pattern where health improves as socioeconomic status rises and worsens as it falls
65
Define Social Capital
The networks of relationships among people who live and work in a particular society, enabling that society to function effectively
66
What is the idea proposed in this lesson? - social capital theory
Social capital may be able to buffer the side effects of low social determinants of health
67
What are the prominent types of social capital
*Bridging – connections within diverse social networks - Bonding – close-knit connections from intimate social networks
68
list example measures of social capital.
*Trusting your neighbor *Knowing who your state senator is
69
*According to the matching law, behavior will reliably occur if what two things are in balance?
*Amount of effort required to perform the behavior and the size of the re-enforcer or consequence
70
*What is the name for the process by which an immigrant adopts the behaviors and practices of a new culture?
*Acculturation
71
*What are the three types of theories we’ve discussed in this class?
*Intrapersonal, interpersonal, community-level
72
What does satiation mean?
Being fully satisfied, repeated exposure diminishes effectiveness – decreased responsiveness or interest
73
What is contingency reinforcement?
The reinforcement is administered if and only if the behavior occurs
74
What is a strength of intrapersonal models/theories?
They are consistent with the ways in which we currently trat illnesses
75
What are the strengths of community-level (ecological) interventions?
They result in the best long-term effect on changing behavior
76
matching law
The Matching Law, proposed by psychologist Richard J. Herrnstein, states that the proportion of an organism's responses to different choices will match the proportion of reinforcement received from those choices. In essence, it describes the tendency for behavior to distribute in a way that aligns with the distribution of reinforcement among available options.
77
contingency
a contingency is a dependency between events or behaviors, where the occurrence of one event is dependent on the occurrence of another. Contingencies are fundamental to understanding how behaviors are influenced by the consequences that follow them, shaping the likelihood of their occurrence in the future.
78
According to the TRA/TPB, what is the major predictor of behavior?
Intention
79
vicarious experience
learning from observing others to be successful performing the behavior
80
mastery experience
performing the behavior yourself and being successful
81
Verbal persuasion
social support or encouragement
82
Minimizing somatic and emotional states
when we try to influence people’s self-efficacy under conditions where they are highly emotionally energized or charged, we’re not successful
83
Knowledge
information individuals possess about environment, consequences, which influence decision making
84
Situational perception
individuals’ interpretation and understanding of current context, influences likelihood of engaging behavior based on assessment of situation
85
Outcome expectation
individuals’ anticipation of consequences or results of specific behavior, influencing motivation and decision to engage in that behavior
86
Outcome expectancies
overall set of anticipated consequences, both positive and negative, associated with behavior, shaping preferences, choices, and persistence in that behavior
87
Environment
surroundings and external influences that shape behavior
88
Self-efficacy
individuals’ belief in their capability to successfully perform task or behavior, influencing motivation
89
Reinforcement
consequences that follow behavior and influence likelihood of behavior being repeated
90
Intention
planned or anticipated course of action – readiness to commit to behavior
91
Attitudes
overall evaluation or feeling of preference toward behavior
92
Behavioral beliefs
expectations regarding consequences or outcomes associated with behavior
93
Outcome evaluation
assessing value of outcome or consequences with the behavior
94
Subjective norms
individuals’ belief regarding attitude and opinion of significant others in life
95
Normative beliefs
perceptions or thoughts person has about how significant others would prefer them to behave
96
Motivation to comply
individuals’ willingness to conform to preference of others
97
Perceived behavioral control
extent of control individuals perceive they have over behavior
98
Perceived power
perception of ease or difficulty of behavior
99
Control beliefs
belief about internal and external factors that have potential to inhibit or facilitate performance of behavior
100
Perceived susceptibility
belief regarding likelihood of reaching harmful state in specific behavior
101
Perceived severity
belief about the extent of harm that can come from specific behavior
102
Perceived benefits
belief in advantages of specific behavior
103
Perceived barriers
belief about obstacles associated with adopting new behavior
104
Modifying variables
influences – external factor that my influence how the constructs interact
105
Cues to action
forces that prompt individual to feel the need to act
106
Consciousness raising
experiential process – elevate awareness regarding cause, consequence, potential solution for problem
107
Dramatic belief
intensify emotional arousal about behavior, highlight relief that can result from making a change – emotional response to show need for change: contemplation
108
Self- re-evaluation
individuals’ assessment of their self-image in relation to a new behavior: contemplation
109
Environmental re -evaluation
how a behavior impacts one’s environment and how changing that behavior would influence the surroundings – broader consequences of actions: contemplation and preparation
110
Counterconditioning
learning new behavior to replace existing unhealthy behavior: preparation and action
111
Contingency management
using reinforcement and punishment to encourage or discourage behaviors: action and maintenance
112
Stimulus control
modifying environment to enhance cues for healthy behavior while diminishing cues for unhealthy behavior: action and maintenance
113
Intrapersonal
factors that are specific to individuals’ personal characteristics
114
Interpersonal
influences within individuals’ immediate social environment
115
Organizational
within larger organizations and institutions that shape individuals’ health and behavior – work, community groups
116
Community
broader influence – neighborhoods, communities
117
Policy
laws, regulations, societal cultural norms that shape behaviors at population level
118
individual level
factors inherent to an individual
119
local network
perceptions, belief, attitude shared among individuals within specific social units
120
community
beliefs within broader social unit of community
121
society
highest level of social organization – multiple communities or groups
122
tenets of social cognitive theory (5)
- Vicarious capability – learning from observing others - Symbolizing capability – symbols to meaning – interpretation - Forethought capability – behavior is purposive and regulated by prior thought - Self-regulatory capability – setting internal standards for behavior - Self-reflection capability – analysis of experience about one’s thoughts
123
List example measures of social capital.
* Trusting your neighbor * Knowing who your state senator is * Family supporting each other * Community organization participation * Networking
124
limitations of self-efficacy
- Situation specific - Influence of external factors - Outcome expectancies - Emotional states - Subjective
125
model
simplified representation of system, process, concept to understand aspect of world – make predictions and test hypothesis
126
Theory
well substantiated explanation of aspect of world – undergone testing. Framework for understanding and organizing, guiding research and predictions
127
is a model or theory bigger?
theory
128
What are the effects on behavior of punishment and reinforcement, e.g., what happens to future rates of recidivism and the duration of behavior change?
oPunishment – temporary, emotional response, not lasting oReinforcement – increase likelihood of reinforced behavior happening again, more likely to be sustained
129
why is punishment a less effective behavior change strategy
Punishment is often less effective for behavior change because it typically leads to temporary suppression, negative emotional responses, and the risk of unintended side effects, while failing to address underlying causes and potentially decreasing motivation for positive change. Positive reinforcement and proactive strategies tend to be more effective in fostering lasting behavior change by emphasizing positive associations and addressing underlying motivations.
130
Understand the interplay between pros and cons at the various stages in the stages of change
o Precontemplation – limited awareness for need to change, don’t know negative consequences of current behavior o Contemplation – aware of need for change and benefits, recognize pro and con – uncertain about decision o Preparation – intention to change is strong, seek information and support, concern about obstacles and difficulty o Action – engaged in behavior, experiencing benefits – facing challenges and obstacles o Maintenance – continued commitment to change and gaining confidence, potential for relapse or setback, - need ongoing effort
131
is topography or function more important to address
function
132
origins of social capital
- Pierre Bourdieu and Robert D. Putnam
133
Recognize shortcomings of alternative approaches to applied behavior analysis.
- Lack of empirical support - Less measurable - Limited emphasis on emotion

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