Name the 3 social influence approaches in public health programs.
Provide role modeling
Provide supportive helpers
Several theories incorporate social norms (SCT, TRA, etc.).
Name the two types of social norms.
What are descriptive norms?
What you think most people do
What are injunctive norms?
What other people want you to do
Perceived - what you think they want you to do
Expressed - What they say they want you to do
Where do "perceived norms" come from?
Direct observation of others' behavior (vicarious learning, limited sample, behavior may be misinterpreted)
What other people say about typical behavior ("No one around here does that")
What media shows/says
Perceived norms can be correct or incorrect
How do norms influence behavior?
Direct imitation - ofent unaway of our tendency to imitate
Tendency to conform
What are some assumptions for the "social norms" approach to behavior change?
Norms about important behaviors are often incorrectly perceived - false consensus
Actions are based on those misperceived norms
Providing correct information will correct the misperceptions
When misperceptions are corrected, action will follow the new norm
Everyone drinks on weekends - if correct, then norms support behavior
Campaigns/posters - majoirty of action, descriptive norms (perceived numbers do/don't)
List the 5 things that must be addressed to use social influence theory for health behavior change.
Need to establish that norms have been misperceived
Misperception needs to be in the direction of over-stating unhealthy behavior
Corrected perception needs to be substantial in the direction of the healthier behavior (won't work if the norm is only off a little)
Audience needs to believe the corrected information
Norm needs to apply to appropriate peer group (own social group)
List 4 things that determine successful social norms campaigns.
Campaign applies to a well-defined social group (campuses, schools, local communities)
Formative research establishes actual norms
Organization providing the campaign is perceived as credible
Research should establish that the perceived norm has changed and the behavior has changed
Describe an example of an approach to changing norms.
Certain behavior change programs have been shown to impact norms in addition to changing healthy behavior (e.g. smoke free public places)
Improve health of individuals by reducing smoking
Improve health of others by reducing exposure to second hand smoke
Indirectly affect smokign rates by changing perceived norms about the acceptability of smoking (especially kids) - can be subtle
Describe role modeling.
Imitation / observational learning
One-on-one, rather than a general norm
Behavior change program which emphasize role modeling mainly directed toward "authority figures" (parents, teachers, health professionals; implication that authorities are particularly important role models)
Describe programs based on role modeling.
Depend on role models to change behavior for sake of others
Parents, other relatives may be willing
More distant individuals hard to convince (policies in schools & other organizations may require certain behaviors for the sake of role modeling, establishment of norms)
Depends on person A changing behavior for person B
Better for parents, not so much for others (teachers, etc.)
Describe "Support Person" interventions.
Increase quantity and/or quality of support
Mostly use "introduced" support person
Examples: weight loss/physical activity, lay health advisors, buddy system, breastfeeding peer support counselors, etc.
List issues with "support person" interventions.
What exactly is the support person doing or saying? Is it helpful? They can stray off message, not advise or deliver as prescribed.
Is the support person credible? Peers may be de-valued vs. doctor, nurse, professional.
Behavior change outcomes for the targe population can be difficult to assess. Research difficult to capture due to 1 step removed.
Describe methods of educating "naturally occurring" support persons.
Members of target individual's own social network (friends, relatives, spouses, children)
Trained to be more supportive; Ways to be helpful, active support - child care, praise for accomplishments; Ways not to cause backlash; nagging, criticizing, social undermining efforts
Training often based on SCT
Provide some examples of support person studies.
Confidante study - attempted to train female friends and relatives of pregnant smokers to help them quit; modestly successful but difficult to implement
Telephone counseling of individuals to help others quit smoking; success reported by self-report of the support person
Various studies have attempted to work with spouses of people trying to quit; not very successful overall; spousal communciation patterns may be entrenched
List some issues with support persons studies.
Equally difficult to get support person to change as to get an individual to change
Must consider entire social network; other members of network may continue to be negative despite other positive change; networks tend to change during the intervention, which make it difficult to sustain
Difficult to assess success with the targeted individual