Illness analysis tied with Sick Role Model

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COMM3313:  COMMUNICATION AND PUBLIC HEALTH

Introduction: Putting Theory into Practice in Public Health

THE HISTORY OF HEALTH COMMUNICATION AS A FIELD OF STUDY

 Fields:  Interpersonal comm.  Sociology  psychology  Social Cognition  Social work

 Topics of interests:  Provider‐patient comm.  Patient‐caregiver interactions  Social support  Social stigma  Information/uncertainty 

management

 Fields:   Organizational Comm.  Communication & Technology  Business  Management

 Topics of interests:  HMOs  risk communication  Interdisciplinary health teams  Inter/intraorganizational

communication in health  settings

 Technology implementation

Interpersonal Contexts Organizational Contexts

THE HISTORY OF HEALTH COMMUNICATION AS A FIELD OF STUDY

 Fields:  Persuasive communication  Interpersonal communication  Media studies  Public health  Social work

 Topics of interests:  Behavioral Change

 One‐time health behavior  Long‐term lifestyle change/ maintenance

 Social Inequality  Policy, advocacy, & organizational changes  Interests in multi‐level interventions: individual, interpersonal, community, institutional, 

policy levels

Public Health: Health Education and Health Campaigns

THE INCREASING INTERESTS IN PUBLIC HEALTH

 Chronic illness as a long‐term life issues

 Advancement in medicine

 Identification of illnesses

 Preventive care as standards of care

 Vaccination

 Genetic testing

 Exercise

 Awareness in cultural & environmental factors/concerns

 Social stigma

 Ethnic/racial/global health disparity

HEALTH EDUCATION

 Scope:  Individual’s behavior → System‐level concerns

 Definitions:  Bringing about behavioral changes in individuals, groups, and 

larger populations from behaviors that are presumed to be  detrimental to health, to behaviors that are conductive to  present and future health (Simonds, 1976)

 Any combination of learning experiences designed to  facilitate voluntary adaptations of behavior conductive to  health (Green, 1990)

 Emphasis:  Voluntary, informed behavior changes

WHAT IS HEALTH BEHAVIOR?

 Preventive health behavior  Any activity undertaken by an individual who believes 

himself/herself to be healthy, for the purpose of preventing  or detecting illness in an asymptomatic state

 Illness behavior  Any activity undertaken by an individual who perceives 

himself/herself to be ill, to define the state of health, and to  discover a suitable remedy

 Sick‐role behavior  Any activity undertaken by an individual who considers 

himself/herself to be ill, for the purpose of getting well.

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PARSON’S SICK ROLE

The sick person

 is exempted from normal social role responsibilities

 cannot get well by an act of decision or will

 is obligated to get well

 is obligated to seek technically competent help

HEALTH EDUCATION

 Health behavior is the central concern of health  education

 Settings for HE: evolved from three settings: communities, school, & patient care sites

now also include: workplace,  consumer market place, homes

 Audience for HE:   individuals, groups, organizations who share similar  characteristics:

 sociodemographic

 racial,

 life‐cycle‐stage

 disease or at‐risk status.

THEORY, RESEARCH & PRACTICE IN HEALTH BEHAVIOR & HEALTH EDUCATION

 Research in Health Education & Health Behavior (HEHB)  improves the health of society. 

 Theories must be tested in the “real world” in order to  determine efficacy. 

 The use of theories asses the impact of interventions. 

WHAT IS THEORY?

 “a set of interrelated concepts, definitions, and  propositions that present a systematic view of events or  situations by specifying relations among variables in  order to explain and predict events”

 Theories can only be used properly when they are filled  with practical topics, goals and problems.

CONCEPTS, CONSTRUCTS, & VARIABLES

 Concepts:

 the building blocks of a theory. 

 Constructs:

 when the “building blocks” have been accepted for use in a  theory.

 Variables:

 the operational forms of a construct, how a construct is  measured in a certain situation. Variables and constructs  should match when a theory evaluation is being performed. 

PRINCIPLES AND MODELS

 Principles

 General guidelines for action

 Broad and non‐specific

 Based on precedent or history

 Models

 models draw on a number of theories to help understand a  specific problem in a particular setting or context

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PARADIGM IN HEALTH EDUCATION AND HEALTH BEHAVIOR

 A paradigm is a “basic schema the organizes our broadly  based view of something”

 they include theory, application, and instrumentation and comprise  models that represent traditions of scientific research

 Paradigm in HE & HB: logical positivism and logical empiricism

 These are related to: 

1. An emphasis on use of induction, feelings, sensory experiences or  personal judgments

2. The view that deduction is the standard or verification or  confirmation of theory, so the theory must be tested through  empirical methods and observation.

INTERPERSONAL THEORIES OH HEALTH BEHAVIOR

 Theories for Exam 1

 Health Belief Model (HBM)

 The Theory of Reasoned Action and the Theory of Planned  Behavior (TRA/TPB)

 The Transtheoretical Model (TTM)

 Each theory recognizes that people in different  situations need different information and intervention

 What makes a good theory?

6 CRITERIA USED TO EVALUATE THEORY

 Theoretical Scope  How general is the theory? That is, how widely applicable is it? 

 Appropriateness  Theories are often evaluated based upon how well their epistemological, 

ontological, and axiological assumptions relate to the issue or question being  explained.

 Heuristic value  The success of a theory may rest on how readily other researchers may continue 

to do fruitful work in reaction or support. 

 Validity  Are the arguments internally consistent and are its predictions and claims 

derived logically from its assumptions? Many also require that theories be  falsifiable; that is, theories that present predictions that‐‐if they prove to be  incorrect‐‐invalidate the theory.

 Parsimony  Theory should provide the simplest possible (viable) explanation for a 

phenomenon. "Aha!" moment in which an explanation feels as if it fits. 

 Openness  Theories, perhaps paradoxically, should not exist to the absolute exclusion of 

other theories. Theory should not be dogma.

THEORY AS POINTS OF VIEW

 A theory is not "true," or "false”, but rather better or  worse at explaining the causes of a particular event. 

 Especially within the social sciences, we may find several  different theories that each explain a phenomenon in  useful ways. There is value in being able to use theories  as "lenses" through which you can understand  communication, and through which you can understand  the world together with other scholars.

OBJECTIVES OF COMM3313

 Understand why and how individuals adopt and/or  maintain health‐facilitating/compromising behaviors

 Learn about the specific variables/constructs of different  theories 

 Have hands‐on practice in designing and executing  health campaign that are based on theories of  behavioral change