Course: Integrating Social and Behavioral Theory into Public Health Part II: Mezzo/Micro-Level Theories

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Topic Activities

Session 16: Life-Course Perspective

A life-course developmental perspective can be critical for understanding social phenomena and planning appropriate public health interventions. We will focus on two main topic areas:

  1. a social perspective on development - how relationships shape our sense of who we are and help us learn about ourselves and about the world. We talk about scaffolding and how the discovery of mirror neurons adds validity to this concept.
  2. stage models of development and their utility. We review some of the empirical data about the way in which developmental states do or don't constrain abilities

Lecture: Life-Course Perspective


Sessions 17 & 18: Intra-personal Aspects of Health Behavior

These lectures present some of the key theoretical paradigms that link the micro social environment to health-related behavior.  We discuss classical and operant conditioning, the social cognitive model, the health belief model, the somatic marker hypothesis, and the transtheoretical model, and touch on Sunstein and Thaler's "choice architecture" as a related structural intervention.  We spend a good deal of time talking about the unreliability of cognition ("bounded rationality") as a determinant of behavior.

Lecture: Intra-personal Aspects of Health Behavior

Lab Session 4: Decision-Making


Session 19: Theories of Health Behavior Based on Interpersonal Influence

In this lecture, our perspective will broaden from intra to interpersonal influences on health behavior. We review data suggesting that social proximity is a powerful influence on health behavior, and revisit the mirror neuron system as a mechanism that unconsciously intuits the meaning of other people's actions.  We then look again at the role of emotions but this time the so-called social emotions that influence our response to the behavior of others.  We also talk about peer education programs and the kinds of information that seem best transmitted in that context.

Lecture: Theories of Health Behavior Based on Interpersonal Influence


Session 20: Workshopping Narratives, Adapting Written Narratives to Audio Format

Ms. Christine Buttdorff, formerly a reporter for public radio and now a doctoral student in health economics, will talk about how to take a story idea and translate it into a short audio piece or report.  This will be a lead-in for a field trip (not in class time) to local public radio station, WYPR, where Aaron Henkin (producer of the program "The Signal") will assist those who wish to make a studio recording of one of their narrative pieces.

Lecture: Writing for Radio

Workshopping Narratives

Adapting to audio

Narrative Example by Rachel Zelkowitz

Session 21: Models of Patient-Provider Communication

Dr. Debra Roter will talk about conceptual models of patient-provider communication and their origins in social and communication theory. She will talk about methods of measurement and implications for health care and health care interventions. We will talk about where patient-provider communication fits into the larger social model of health - potentially as something that mediates mezzo-micro relationships or that moderates relationships between the micro level and behavior.

Lecture: Models of Patient-Provider Communication


Session 22: Implications of Health Literacy for Clinical Interpersonal Interactions

Dr. Erby's talk will focus on how literacy and health literacy are conceptualized and measured. Literacy forms a major barrier to engaging in health behaviors and health care. The lecture includes interventions to address the barrier of decreased health literacy.

Lecture: Implications of Health Literacy fo Clinical Interpersonal Interactions


Small group discussion of Salmon P, Young B. Core assumptions and research opportunities in clinical communication. Patient Educ Couns. 2005 Sep;58(3):225-34.

Session 23: Sex and Gender

We return to the macro level to discuss sex and gender, areas where biology and social structure interact to exert significant influence over an individual's health status. This lecture will define sex and gender, explore gender inequalities and health status, look at ways in which gender functions differently in different national and cultural contexts as a determinant of health, and explore various causal models attempting to explain sex and gender differences in health status.

Lecture: Sex and Gender

Lecture: Sex, Sexuality, and Health


Session 24: Midterm Quiz and Media/Gender Lab


Lab 5: Media Effects and Gender

Session 25: Health education and health promotion: making change through behavioral interventions

The field of health promotion has been a mainstay of public health for decades, and gained prominence with publication of the first objectives for the nation. As a discipline, its overarching goals and principles have remained constant, while methods and strategies for successful behavior change programs have advanced through research and in response to changes in the patterns of disease and injury over time. This lecture and discussion will briefly review the history of health promotion, highlight selected successes and failures, and provide an example of a widely used planning framework that integrates theory and facilitates building comprehensive behavior change programs.

Lecture: Health education and health promotion: making change through behavioral interventions (Not Available)


Session 26: Program Evaluation

We all have an intuitive idea of what is meant by evaluation. This talk will focus on three aspects: different sorts of evaluation jargon across fields, thinking about evaluation in a multi-level way that follows an ecologic model like the one we have been following, and thinking about alternatives to randomized trials.

Lecture: Program Evaluation

Lab 6: Rapid Assessment for Program Evaluation


Session 27: Intervention example: making change in clinical settings

This session talks about the failure of guidelines to influence clinician behavior. It examines the social structure of clinical settings and discusses options for behavior change.  This is an opportunity to think about change in a single setting from an ecologic or social network perspective.

Lecture: Making change in clinical settings (Not Available)


Session 28: Discussion of Berkman/Glass model

Small group discussion � review of the Berkman/Glass model, proposals for additions and modifications.  See the guide to this session posted on Course Plus.  Think back to the original discussion of the model, and your drawing in the small group discussion of the Chandola paper.

The goal of this session is to do hands on work making a flow chart that is meaningful to you Take a specific health behavior and try to sketch out a model using elements of the Berkman-Glass model.

Small group discussion

Health behavior flow chart

Session 29: Narrative readings
Session 30: Final exam