C-CHANGE
C-Channel:
Issue 39 | MARCH 2012
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Theories and Models Applied to Social and Behavior Change Communication (SBCC)

Of Interest…

C-Change has recently launched a new and improved C-Hub website. C-Hub is an online resource of health communication materials for development. The goal of C-Hub is to provide access to health communication materials and campaigns, in areas such as HIV and AIDS; sexual and reproductive health; infectious diseases, including malaria, TB, and avian influenza; environmental health; maternal and child health; and non-communicable diseases. Access health communication materials in print, audio, and video formats at www.c-hubonline.org.

C-Channel presents six articles that focus on some of the theories and models on which health-related behavior and social change communication is based. The first concludes that theory development has not kept pace with health promotion practice; the second discusses and recommends the use of the social action theory; and the third examines how health behavior theories are applied to mobile interventions. The fourth article centers on the socio-ecological model, and the levels addressed by health promotion interventions described in Health Education & Behavior in the past 20 years. The last two articles address models and frameworks for HIV-prevention interventions. One outlines an integrated conceptual framework that links youth exposure to community violence and HIV risk, and one addresses the inclusion and exclusion model of HIV-related behavior.

C-Change has published the Voluntary Medical Male Circumcision (VMMC) Communication Materials Adaptation Guide to provide comprehensive guidance for programs adapting VMMC communication materials. While the examples in the guide are from C-Change’s work in Kenya on VMMC communication, the 10-step process is applicable across multiple health areas. To download, visit the C-Change website. The guide is also available on C-Hub, along with other VMMC communication materials.

In this issue

Theories and Models Applied to Social and Behavior Change Communication (SBCC)

1. Theory development in health promotion: Are we there yet?

2. Theory development for HIV behavioral health: Empirical validation of behavior health models
ONLINE FULL TEXT

3. Health behavior models in the age of mobile interventions: Are our theories up to the task?
ONLINE FULL TEXT

4. Social ecological approaches to individuals and their contexts

5. Conceptual model linking community violence exposure to HIV-related risk behaviors
ONLINE FULL TEXT

6. Modeling structural, dyadic, and individual factors
ONLINE FULL TEXT


1. Theory development in health promotion: Are we there yet?

Authors: Crosby R; Noar S
Institutions: University of Kentucky and Rural Center for AIDS/STD Prevention, Bloomington
Source: Journal of Behavioral Medicine 2010 33(4): 259-263, doi: 10.1007/s10865-010-9260-1.

ABSTRACT

Theory development has not proceeded at a pace commensurate with the evolution of health promotion practice. At least three examples of this disparity are apparent: (1) theory is developed in an evidence-based paradigm rather than a practice-based paradigm, (2) a substantial majority of health behavior theories exist at the individual level, thereby neglecting contextual realities that shape behavior, and (3) “accessibility” levels of theory to practitioners may be quite low in comparison to the growing demands to prevent disease through expanding health promotion practices. The challenges of health promotion demand a great deal more attention to developing theories that reflect the reality of broad influences on health behavior. One critical question that must be answered involves setting limits regarding the realistic role of behavioral interventions in public health practice. The evolution of theory should be practice-based, largely ecological in nature, and the resulting theories should be easily accessible to practitioners.

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2. Theory development for HIV behavioral health: Empirical validation of behavior health models specific to HIV risk

Authors: Traube D; Holloway I; Smith L
Institution: School of Social Work, University of Southern California, Los Angeles
Source: AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV 2011 23 (6): 663–670.

ABSTRACT

In the presence of numerous health behavior theories, it is difficult to determine which of the many theories is most precise in explaining health-related behavior. New models continue to be introduced to the field, despite already existing disparity, overlap, and lack of unification among health promotion theories. This paper will provide an overview of current arguments and frameworks for testing and developing a comprehensive set of health behavior theories. In addition, the authors make a unique contribution to the HIV health behavior theory literature by moving beyond current health behavior theory critiques to argue that one of the field's preexisting, but less popular theories, Social Action Theory (SAT), offers a pragmatic and broad framework to address many of the accuracy issues within HIV health behavior theory. The authors conclude this article by offering a comprehensive plan for validating model accuracy, variable influence, and behavioral applicability of SAT.

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3. Health behavior models in the age of mobile interventions: Are our theories up to the task?

Authors: Riley W1; Rivera D2; Atienza A1; Nilsen W1; Allison S1; Mermelstein R3
Institutions: 1 National Institutes of Health, Bethesda, Md., USA; 2 Ira A. Fulton School of Engineering, Arizona State University; 3 Department of Psychology and Public Health, University of Illinois at Chicago
Source: Transl Behav Med. 2011 Mar 1;1(1):53-71.

ABSTRACT

Mobile technologies are being used to deliver health behavior interventions. The study aims to determine how health behavior theories are applied to mobile interventions. This is a review of the theoretical basis and interactivity of mobile health behavior interventions. Many of the mobile health behavior interventions reviewed were predominately one way (i.e., mostly data input or informational output), but some have leveraged mobile technologies to provide just-in-time, interactive, and adaptive interventions. Most smoking and weight loss studies reported a theoretical basis for the mobile intervention, but most of the adherence and disease management studies did not. Mobile health behavior intervention development could benefit from greater application of health behavior theories. Current theories, however, appear inadequate to inform mobile intervention development as these interventions become more interactive and adaptive. Dynamic feedback system theories of health behavior can be developed utilizing longitudinal data from mobile devices and control systems engineering models.

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4. Social ecological approaches to individuals and their contexts: Twenty years of Health Education & Behavior health promotion interventions

Authors: Golden S; Earp J
Institutions: University of North Carolina at Chapel Hill
Source: Health Education & Behavior 2012, Jan 20 [epub ahead of print] doi: 10.1177/1090198111418634.

ABSTRACT

Social ecological models that describe the interactive characteristics of individuals and environments that underlie health outcomes have long been recommended to guide public health practice. The extent to which such recommendations have been applied in health promotion interventions, however, is unclear. The authors developed a coding system to identify the ecological levels that health promotion programs target and then applied this system to 157 intervention articles from the past 20 years of Health Education & Behavior. Overall, articles were more likely to describe interventions focused on individual and interpersonal characteristics, rather than institutional, community, or policy factors. Interventions that focused on certain topics (nutrition and physical activity) or occurred in particular settings (schools) more successfully adopted a social ecological approach. Health education theory, research, and training may need to be enhanced to better foster successful efforts to modify social and political environments to improve health.

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5. Toward a conceptual model linking community violence exposure to HIV-related risk behaviors among adolescents: Directions for research

Authors: Voisin D1; Jenkins E2; Takahashi L3
Institutions: 1 School of Social Service Administration, University of Chicago; 2 Department of Psychology, Chicago State University; 3 School of Public Affairs, University of California at Los Angeles
Source: Journal of Adolescent Health 2011 49(3): 230–36

ABSTRACT

Purpose: To present a conceptual framework which accounts for the relationship between community violence exposures (CVEs) and youth HIV risk behaviors.
Methods: This article provides an overview of existing research on the links between CVE and HIV risk for youth and offers a conceptual framework for clarifying how CVE might contribute to HIV sexual risk behaviors.
Results: Increasing empirical findings substantiate that the links between CVE and HIV risk behaviors among youth are mediated by psychological problem behaviors, low school success rates, and negative peer influences.
Conclusions: Researchers have identified the behaviors that place teens at risk for becoming infected with HIV. However, most scholars have overlooked the potential importance of CVE in influencing such behaviors. This article presents new directions for adolescent research and HIV interventions on the basis of an integrated conceptual framework.

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6. Modeling structural, dyadic, and individual factors: The inclusion and exclusion model of HIV -related behavior

Albarracin D1; Tannenbaum M1, Glasman L2; Rothman A3
Institutions: 1 Department of Psychology, University of Illinois; 2 Center for HIV Prevention Research, Medical College of Wisconsin; 3 Department of Psychology, University of Minnesota
Source: AIDS and Behavior 2010 14:S239–249 DOI: 10.1007/s10461-010-9801-1.

ABSTRACT

Changing HIV-related behaviors requires addressing the individual, dyadic, and structural influences that shape them. This supplement of AIDS & Behavior presents frameworks that integrate these three influences on behavior. Concepts from these frameworks were selected to model the processes by which structural factors affect individual HIV-related behavior. In the Inclusion/Exclusion Model, material and symbolic inclusions and exclusions (sharing versus denying resources) regulate individuals’ ability and motivation to detect, prevent, and treat HIV. Structural interventions create inclusions that increase one’s ability or motivation to perform these behaviors or exclusions that hinder one’s ability or motivation to execute counterproductive behaviors. The need to expand research regarding multilevel influences on HIV-related behavior is also discussed, particularly concerning further understanding of sustained behavior change and effective dissemination of evidence-based intervention strategies.

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This publication is made possible by the generous support of the American people through the United States Agency for International Development (USAID) under the terms of Agreement No. GPO-A-00-07-00004-00. The contents are the responsibility of C-Change, and do not necessarily reflect the views of USAID or the United States Government.

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