Kines quiz 3

What is the goal of the Social Cognitive Theory (SCT)

To explain how people regulate their behavior through control and reinforcement to achieve goal-directed behaviors that can be maintained over time.

Reciprocal determinism

How personal, behavioral, and environmental factors are continually influencing each other.

What are the SCT constructs?

Personal factors, behavior, and environmental factors.

Personal factors, including cognition and emotional influences on behavior:

personal abilities for processing information, applying knowledge, and changing preferences (self efficacy, outcome expectations, knowledge)

Environmental influences on behavior:

Physical, social, and cultural factors in a person's environment that affect their behavior (observational learning, normative beliefs, social support, opportunities/barriers)

Supporting behavioral factors:

actions taken by people that can be classified as either health-enhancing or health-compromising (behavioral skills, intentions, reinforcement/punishment)

Behavior therapy principles for modifying behavior:

- Behavior that is reinforced (rewarded) increases

- intermittent (vs. continuous) reinforcement is highly effective and longer lasting

- behavior that is punished decreases

- Exposure to a feared stimulus can extinguish that fear

What is self-efficacy?

A person's belief in their ability to successfully perform a specific behavior or task to achieve desired outcomes.

What are the 4 primary sources of self-efficacy?

1. Mastery Experiences

2. Vicarious Experiences (modeling)

3. Verbal persuasion

4. Improving somatic and emotional states

Mastery experiences

Enabling the person to succeed in attainable but increasingly challenging desired behaviors. Success builds confidence; failure can undermine it.

Example of Mastery Experiences

Gradually increasing walking distance each week strengthens confidence to complete a 5K

Vicarious experiences (modeling)

Showing the person that others like that person can do it increases the belief that "I can do it too"

example of Vicarious experiences

watching a peer successfully quit smoling using a similar strategy to the one you're planning to use

Verbal persuasion

Support and positive feedback from credible others enhance belief in ability. Telling someone they can do it, can induce first efforts toward behavior change.

Example of verbal persuasion

a coach or healthcare provider telling someone that they have the skills to manage their diabetes

Improving somatic and emotional states

Making sure people are well rested and relaxed before attempting a new behavior.

Example of improving somatic and emotional states

Viewing nervousness as excitement rather than fear improves confidence and performance on a math exam

Ways to build self-efficacy:

Build health promotion programs with components that engage each primary source of self-efficacy

Bandura's social learning theory

Emphasizes how modeling and enhancing people's sense of efficacy can help them improve their lives

Limitations with social cognitive theory:

- Assumes changes in the environment will lead to changes in the person

- Unclear how influential each loosely organized factor is (person, behavior, and enviroment)

- does not focus on emotion or motivation

- broad, so it's difficult to operationalize in its entirety

Parental, infant, and child health concerns the health status of people with uteruses of....

childbearing age, infants, and children

The cognitive and physical development of infants and children may be influenced by the:

Health, nutrition, and behaviors of their parent during pregnancy and early childhood.

Teengae births:

- more likely to result in serious health consequences for the pregnant teen baby

- Pregnant teens are less likely to receive early prenatal care

- can negatively impact pregnant teens' educational and job opportunities

Family Planning:

Determining the preferred number and spacing of children and choosing the appropriate means to accomplish it

group less likely to have access to family planning services:

Black women, Hispanic women, women with lower levels of education and income, and women without health insurance

Family planning services include:

- contraceptive services

- pregnancy testing and counseling

- basic infertility services

- breast and pelvic examinations

- much more

What is the Title X: Family Planning Act?

- Federal program that provides funds for family planning services for low-income people

Infant mortality has declined due to:

- improved disease surveillance

- advanced clinical care

- improved access to health care

- better nutrition

- increased education

leading causes of infant death:

birth defects, preterm/low birth weight, SIDS

Unintentional injuries are the leading cause of death in children, provide example:

Motor vehicle deaths, especially those not wearing seatbelts

Patient centered medical home:

Provides comprehensive primary care that facilitates partnerships between patients, clinicians, medical staff, and families

Key stressors for parents:

1. Economic strain

2. Time pressures

3. Isolation and loneliness

4. cultural expectations

Mental health conditions disproportionately affect certain groups of parents, reflecting broader social determinants of health

- community violence

- poverty

- job instability/unemployment

-racism

-discrimination

-intimate partner violence

-single parent households

-chronic medical conditons/disabilities

-military families

impacts on health and family

Chronic stress increases risk for depression, anxiety, and burnout among parents. Parental mental health issues can lead to behavioral, emotional, and developmental risks for children.

Moving upstream Examples

1. Policy solutions

2. Employer role

3. Community role

4. Health sector

Policy solutions:

expand paid leave, child-care access, and affordable mental health care

employer role:

create flexible, family-friendly workplaces

community role:

foster social connections and normalize support for parents

health sector:

integrate mental health and primary care; identify at-risk parents early

Behavioral patterns in adolescence help determine:

- socio-economic status

- current and future health

Health and social concerns of adolescents:

- academic problems and dropping out of school

- psychological disorders

- smoking/nicotine use

- substance use

- motor vehicle collisions

- nutrition and weight conditions

- sexually transmitted infections, including human immunodeficiency virus (HIV)

- unintended pregnancies

- homelessness

- homicide

- suicide

Since the 1990s...

• Drinking-and-driving is down almost 50 percent

• School fights are down 50 percent

• Sex before 13 is down more than 70 percent

• School bullying is down• And LGBTQ acceptance is up

• But levels of teen sadness have risen

Causes of mortality (adolescents)

•Unintentional injuries, mainly motor vehicle crashes (39.9%of deaths)

•Suicide (17%)

•Homicide (16.6%)

mortality has declined in adolescents over past several decades thanks to:

- advances in medicine

- injury and disease prevention

- behavior change

Chronic diseases often result from behaviors begun during adolescence:

Ex; tabacco, alcohol, drugs, poor diet, sedentary behavior

Health behaviors of high school students:

• Unintentional injuries (seat belt use; drunk driving)

• Violence

• Tobacco use

• Alcohol and other drugs

• Unintended pregnancies and STIs

• Physical activity and sedentary behaviors

• Overweight and weight control

Health behaviors of college students:

• Unintentional injuries

• Tobacco and marijuana use

• Alcohol and other drugs

• Unintended pregnancies and STIs

Protective factors - individual or environmental factors that:

- reduce effects of stressful life events

- increase ability to avoid risks

- promote social and emotional competence

- enhance resiliency

Resilience

Able to adapt to life's misfortunes and setbacks

Factors promoting resilience:

- family support and monitoring

- caring adults

- positive peer groups

- strong sense of self, self-esteem

- future aspirations

- engagement in school and community activities

Types of cancer most common in death for adults 45-64

- males: prostate, lung, colorectal

- females: breast, lung, colorectal

Risk factors for chronic disease:

- most significant for adults: tobacco use, harmful use of alcohol, physical inactivity, overweight/obesity, unhealthy diet

Primary, secondary, and tertiary prevention efforts for adults:

• Primary: Exercise and nutrition programs

• Secondary: Self- and clinical screenings to identify and control disease processes

• Tertiary: Medication compliance

Variables impacting health

• Marital status

• Living arrangements

• Geographic distribution of older adults

• Economic status

• Education

• Housing

Top causes of death for older adults in 2020

- heart disease

- cancer

- COVID-19

Medicare

Primary source of payment for healthcare services of older adults

Ageism

Prejudice and discrimination against older adults

Aging can alter these needs in unpredictable ways:

- income

- housing

- personal care

- health care

- transportation

- community facilities and services

Health promotion programming

- is an important tool for community and public health professionals

- Health education is only a part of health promotion

- health promotion: more encompassing than health education

program planning

- a process by which an intervention is planned

- may or may not be connected to community organizing/building

Why is theory important?

To have an impact on health behavior, it helps to understand it

Implication for program design:

helps us address all relevant factors and identify specific strategies to modify those factors

Implications for program evaluation:

helps us specify what indicators will be used to evaluate program effectiveness

Ecological models of health behavior

- public policy

- community

- organizational

- interpersonal

- individual

Socio-ecological model

- policy: local, state, and national laws and policies

- community: norms, culture, availability of resources/opportunities

- organizational: schools, businesses, community organizations

- interpersonal: families, friends, social networks

- individual/intrapersonal: attitudes, beliefs, knowledge, habits, behaviors, skills, history, self-concept

Social determinants of health

Conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality of life outcomes

What are the 5 social determinants of health

education access and quality, health care access and quality, economic stability, social and community context, neighborhood and built environment

Fishbowl metaphor

If the bowl in which a fish lives is dirty, or the glass is cracked and the water is leaking, the fish will never reach its full health potential, despite any individual effort