C-CHANGE
C-Channel:
Issue 40 | APRIL 2012
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Theories and Models Applied to Social and Behavior Change Communication (SBCC), Part 2

Of Interest…

C-Change has developed additional tools for the Voluntary Medical Male Circumcision (VMMC) Communication Toolkit, which was developed in Kenya to create and sustain demand for VMMC as part of a comprehensive HIV-prevention package. Available on C-Hub, these tools include the VMMC Communication Materials Adaptation Guide (to assist programs that lack the resources or time to develop their own VMMC communication materials and products); A Guide to Working with the Media; and a VMMC Video Discussion Guide (which accompanies a 10-minute video that supports the critical role women can play in supporting VMMC for their partners and within their communities).

This issue continues the theme presented in C-Channel 39—theories and models that inform SBCC programs and activities. The first two articles are concerned with ecological models: their use and evolution in health promotion and how social context, as contextualized in the social sciences, can broaden the analytic approach to health behavior. The third article looks at "the state of the science of theory use" for designing and conducting health-promotion interventions; the fourth explores the use of multilevel modelling techniques as a critical process in the development of a theory-based intervention; and the fifth uses the theoretical underpinnings of the transtheoretical model, the theory of triadic influence, and the concept of transfer to investigate the co-occurrence of behaviors. The sixth and last article synthesizes sustainability themes and presents a framework of sustainability indicators for development and social change projects around the world.

Individuals can assess their SBCC skills and their knowledge of theories and models using C-Change's recently released SBCC Capacity Assessment Tool (SBCC-CAT) for Individuals. The tool can be used before and after SBCC training with the C-Modules, and is the third in the series. The other two are the SBCC-CAT for Organizations and the SBCC-CAT for Donors and Networks. The C-Modules are available online, self-paced (and free of charge) through Ohio University. Information on how to enroll is available here.

 

In this issue

Theories and Models Applied to Social and Behavior Change Communication (SBCC), Part 2

1. Ecological models revisited
ONLINE FULL TEXT

2. Theorizing social context: Rethinking behavioral theory

3. Role of behavioral science theory in public health interventions
ONLINE FULL TEXT

4. Contextual knowledge to increase effectiveness of behaviour change interventions
ONLINE FULL TEXT

5. Theory-driven analyses of multiple health behavior change
ONLINE FULL TEXT

6. Sustainability indicators for communication and social change projects
ONLINE FULL TEXT


Theories and Models Applied to Social and Behavior Change Communication (SBCC), Part 2

1. Ecological models revisited: Their uses and evolution in health promotion over two decades

Authors: Richard L1; Gauvin L2; Raine K3
Institutions: 1 Faculty of Nursing and Institute of Research in Public Health, Université de Montréal; Research Centre, Montréal Geriatric University Institute; 2 Léa-Roback Research Centre on Social Inequalities in Health of Montréal, Montréal; Department of Social and Preventive Medicine, Université de Montréal; Research Centre of the University of Montréal Hospital Centre; 3 Centre for Health Promotion Studies, School of Public Health, University of Alberta
Source: Annual Review of Public Health 2011 32: 307-26 DOI: 10.1146/annurev-publhealth-031210-101141.

ABSTRACT

Since the 1980s, ecological models of health promotion have generated a great deal of enthusiasm among researchers and interventionists. These models emerged from conceptual developments in other fields, and only selected elements of the ecological approach have been integrated into them. In this article, we describe the tenets of the ecological approach and highlight those aspects that have been integrated into ecological models used in health promotion. We also analyze how ecological models have been applied to the study of two important public health issues, namely physical activity promotion and the increased consumption of fruits and vegetables, by conducting an archival study of published research. Finally, we make a statement regarding the usefulness of ecological models for research and practice and propose recommendations for future research, program planning, and evaluation.

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2. Theorizing social context: Rethinking behavioral theory

Authors: Burke N1; Joseph G2; Pasick R3; Barker J2
Institutions: 1 Helen Diller Family Comprehensive Cancer Center and Department of Anthropology, History, and Social Medicine, University of California, San Francisco; 2 Department of Anthropology, History, and Social Medicine, University of California; 3 Helen Diller Family Comprehensive Cancer Center, University of California
Source: Health Educ Behav 2009 36(5 Suppl):55S-70S.

ABSTRACT

Major behavioral theories focus on proximal influences on behavior that are considered to be predominantly cognitive characteristics of the individual largely uninfluenced by social context. Social ecological models integrate multiple levels of influence on health behavior and are noted for emphasizing the interdependence of environmental settings and life domains. This theory-based article explains how social context is conceptualized in the social sciences and how the social science conceptualization differs from and can broaden the analytic approach to health behavior. The authors use qualitative data from the Behavioral Constructs and Culture in Cancer Screening study to illustrate our conceptualization of social context. We conclude that the incorporation into health behavior theory of a multidimensional socioculturally oriented, theoretical approach to social context is critical to understand and redress health disparities in multicultural societies like the United States.

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3. The role of behavioral science theory in development and implementation of public health interventions

Authors: Glanz K1; Bishop D2
Institutions: 1 Schools of Medicine and Nursing, University of Pennsylvania; 2 Minnesota Department of Health, St. Paul
Source: Annual Review of Public Health 2010 31:399-418 DOI:10.1146/annurev.publhealth.012809.103604.

ABSTRACT

Increasing evidence suggests that public health and health-promotion interventions that are based on social and behavioral science theories are more effective than those lacking a theoretical base. This article provides an overview of the state of the science of theory use for designing and conducting health-promotion interventions. Influential contemporary perspectives stress the multiple determinants and multiple levels of determinants of health and health behavior. We describe key types of theory and selected often-used theories and their key concepts, including the health belief model, the transtheoretical model, social cognitive theory, and the ecological model. This summary is followed by a review of the evidence about patterns and effects of theory use in health behavior intervention research. Examples of applied theories in three large public health programs illustrate the feasibility, utility, and challenges of using theory-based interventions. This review concludes by identifying cross-cutting themes and important future directions for bridging the divides between theory, practice, and research.

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4. Statistical synthesis of contextual knowledge to increase the effectiveness of theory-based behaviour change interventions

Authors: Hanbury A1; Thompson C1; Mannion R2
Institutions: 1 Department of Health Sciences, University of York; 2 University of Birmingham
Source: Journal of Health Services Research & Policy July 2011 16(3): 167-171.

ABSTRACT

Tailored implementation strategies targeting health professionals' adoption of evidence-based recommendations are currently being developed. Research has focused on how to select an appropriate theoretical base, how to use that theoretical base to explore the local context, and how to translate theoretical constructs associated with the key factors found to influence innovation adoption into feasible and tailored implementation strategies. The reasons why an intervention is thought not to have worked are often cited as being: inappropriate choice of theoretical base; unsystematic development of the implementation strategies; and a poor evidence base to guide the process. One area of implementation research that is commonly overlooked is how to synthesize the data collected in a local context in order to identify what factors to target with the implementation strategies. This is suggested to be a critical process in the development of a theory-based intervention. The potential of multilevel modelling techniques to synthesize data collected at different hierarchical levels, for example, individual attitudes and team level variables, is discussed. Future research is needed to explore further the potential of multilevel modelling for synthesizing contextual data in implementation studies, as well as techniques for synthesizing qualitative and quantitative data.

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5. Health-promoting and health-risk behaviors: Theory-driven analyses of multiple health behavior change in three international samples

Authors: Lippke S1; Nigg C2; Maddock J3
Institutions: 1 Health Psychology/Health Promotion, Freie Universität and Maastricht University, Berlin; 2 Department of Public Health Sciences, University of Hawaii at Manoa; 3 Office of Public Health Studies, University of Hawaii at Manoa
Source: Int. J. Behav. Med. 2012 19:1-13 DOI 10.1007/s12529-010-9135-4.

ABSTRACT

Background: Co-occurrence of different behaviors was investigated using the theoretical underpinnings of the Transtheoretical Model, the Theory of Triadic Influence and the concept of Transfer.
Purpose:To investigate relationships between different health behaviors' stages of change, how behaviors group, and whether study participants cluster in terms of their behaviors.
Method: Relationships across stages for different behaviors were assessed in three studies with N=3,519, 965, and 310 individuals from the USA and Germany by telephone and internet surveys using correlational analyses, factor analyses, and cluster analyses.
Results: Consistently stronger correlations were found between nutrition and physical activity (r=0.16-0.26, p<0.01) than between non-smoking and nutrition (r=0.08-0.16, p<0.03), or non-smoking and physical activity (r=0.01-0.21). Principal component analyses of investigated behaviors indicated two factors: a "health-promoting" factor and a "health-risk" factor. Three distinct behavioral patterns were found in the cluster analyses.
Conclusion: Our results support the assumption that individuals who are in a higher stage for one behavior are more likely to be in a higher stage for another behavior as well. If the aim is to improve a healthy lifestyle, success in one behavior can be used to facilitate changes in other behaviors-especially if the two behaviors are both health-promoting or health-risky. Moreover, interventions should be targeted towards the different behavioral patterns rather than to single behaviors. This might be achieved by addressing transfer between behaviors.

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6. Towards a framework of sustainability indicators for 'communication for development and social change' projects

Authors: Servaes J; Polk E; Shi S; Reilly D; Yakupitijage T
Institutions: SBS Center 'Communication for Sustainable Social Change', University of Massachusetts
Source: International Communication Gazette 2012 74 (2) 99-123 DOI: 10.1177/1748048511432598.

ABSTRACT

This article presents an overview of the emergence of sustainability themes in communication for development and argues that there is an urgent need for a framework of sustainability indicators for communication for development and social change projects around the world. It fills a crucial gap in the growing body of literature by first synthesizing the most relevant data currently produced by global and local institutions, NGOs, UN-based organizations, academics, and professionals regarding assessment indicators for development projects, and second, produces a framework of sustainability indicators that can be used by a wide variety of people in the field to assess the sustainability of existing projects and the sustainable potential of planned ones. It then tests the framework in two representative cases.

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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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