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Name the 3 social influence approaches in public health programs.
- Change norms
- Provide role modeling
- Provide supportive helpers
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Several theories incorporate social norms (SCT, TRA, etc.).
Name the two types of social norms.
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What are descriptive norms?
- What you think most people do
- Usually perceived
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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
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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
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How do norms influence behavior?
- Direct imitation - ofent unaway of our tendency to imitate
- Tendency to conform
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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)
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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)
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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
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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
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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)
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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.)
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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.
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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.
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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
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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
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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
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Social influence as change strategies are ...
one of the least explored.
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