A theory mimics a method of understanding situations/events. It allows us to identify the reason the public health issue exists and to predict possible ideal solutions to address the issue. It can be classified into a set of concepts, propositions, and definitions that illustrate the relationships between the variables to explain/predict the events/situations. Theories must be applicable to a variety of situations and therefore they must be abstract by nature rather than specifying to a topic area/content. They act as guidelines for shapes and counties. They can be depicted by functions which become useful when plugged in with goals, topics, and problems. The primary elements of a theory are concepts. The key concepts of a given theory are its constructs which are developed for the use of a specific theory. This way situation-specific constructs are measured is defined by its variables (the operational forms). Therefore, to identify what needs to be assessed during the evaluation of a theory-driven program, we have to match the variable to the content.
In public health interventions, a theory aids us in planning, implementing and evaluating the public health programs at hand. It uses previous experiences and knowledge to serves as a guide to practitioners when designing interventions. It allows them to maximize efficiency and productivity. Furthermore, the strategies and knowledge predict ideal successful solutions to the desired health outcome. It allows these practitioners to assume what will and won’t be successful and therefore saves them time, effort and funding to achieve ideal health outcomes. Moreover, these theories can be used by practitioners to foresee what to monitor within intervention to further implement an efficient routing process. Interventions are crucial for public health and theories benefit practitioners by setting a focused goal for the desired outcome.
10) 1a. The Transtheoretical Model (TM) is centralized around the idea that behavior change is not based on one event; instead, a staged process. It categorizes 5 stages: pre-contemplation, contemplation, preparation, action, and maintenance. TM references these stages linearly relative to the completion of a behavior. These stages are defined by time intervals. The theory promotes the concept of catering materials to individuals depending on the stage they are in will actually facilitate a behavior change. This means that we should provide individuals certain material depending on their current stage to promote a behavioral change.
1b. The Johnson article applied this model to develop a strategy of weight reduction for obese/overweight individuals at the population level. Their sample consisted of 1277 participants. They were randomly assigned to treatment/control groups who received individualized reports. Their reports provided detailed information about their progress on obesity-relevant behavior change over 4-time intervals. The researchers assessed the individual’s current stage and applied motivational factors to encourage a transition between the linear stages. Their results showed that the treatment groups averaged out to have greater rates of behavior change when using the concept of individual reports. Furthermore, the number of candidates from each treatment group that reached stages 4 and 5 (action and maintenance phases) increased the usage of these individual reports. Therefore, it became safe to say that TM was ideally effective in the design of weight management programs.
1c. Similarity: Both the TM and SEM take into account the individual when discussing a behavioral change. However, this is not done to the same degree. Contrast: TM only focuses on the individual (and inherent) motivations and their effect on behavior change whereas the social-ecological model accounts for the influence of social determinant on the behavior change. Examples of social determinants include the surrounding community, social norms and attitudes (discrimination) and availability of recourses. If both were used to design an intervention, TM can be used to induce the core of the individual’s personal motivation to behavior change, and the social-ecological model will complement TM by addressing the contributions and effects of the social determinants to the issue at hand.
2a. The Health Belief Model (HBM) is centralized around the idea of Health Motivation on the individuals. It somewhat addresses an individual’s perception of the threat posed to them by a health problem, the benefits of avoiding the threat and the factors that influence their decision of action based on the information given to lessen the threat on themselves. It is composed of a number of central constructs that are addressed in order to act on a health issue. They include perceived susceptibility, severity, benefits, barriers, cues to action and individual’s self-efficacy. In other words, it allows us to assess an individual’s perspective and foresee their ‘readiness to change’ based on their confidence/ability to take action. Furthermore, it allows us to view their perception of whether they believe that a change is even possible.
2b. HBM was used in the James paper on 50 African American women (who were obese and interested in losing weight) to basically develop a strategy to effectively lose/maintain weight and avoid obesity. The method used to apply constructs was a qualitative series of 13 questions in seven focus groups. A lead author asked probe questions based on major topics relevant to the constructs of the theory. These included perception of a healthy weight, obesity, overweight, perceived consequences of obesity, information needed to lose weight, sources of dieting and barriers/motivators to weight loss. The questions were used to adopt these women’s opinions and a thematic analysis was used to verify trends in their answers. For perceived susceptibility to obesity, researchers found that women clearly differentiated between the weight categories and believed that their race made them more susceptible and they felt more subject to becoming obese due to culture (correlation between curvy/thick and attraction. For Perceived severity, the women saw obesity a being life threatening/restricting. The perceived benefits mentioned included better appearance and quality of life a however they noted barriers such as lack of knowledge, motivation, time and social support. Furthermore, clues to actions included physical appearance, tight-fitting clothes and personal health problems self-efficacy was affected by past dieting experience. Overall, the HBM provided a good fit for the collected data as it showed several commonalities between these women despite their differentiated background. They were able to develop relevant materials and programs for weight loss.
2c. Similarity: Both the HBM and Social Ecological Model (SEM) have theoretical frameworks that consider the attitude of the individual on a health-related matter. Furthermore, some HBM constructs (those involving perception, barriers, benefits, and susceptibility) are somewhat equivalent to the social-ecological “Individual” concept. Contrast: HBM does not take into account the effects of public health and environmental policies on health outcomes whereas SEM does. If both were used to design an intervention, the HBM can be purposeful to methodically address the interval’s perspective whereas SEM would benefit the design by targeting the social characteristics of behavior change whilst accounting for public health/policy environment.