Theorizing Social Context: Rethinking Behavioral Theory

Helen Diller Family Comprehensive Cancer Center and Department of Anthropology, History, and Social Medicine, University of California, San Francisco, CA 94143-0981, USA.
Health Education & Behavior (Impact Factor: 2.23). 10/2009; 36(5 Suppl):55S-70S. DOI: 10.1177/1090198109335338
Source: PubMed


Major behavioral theories focus on proximal influences on behavior that are considered to be predominantly cognitive characteristics of the individual largely uninfluenced by social context. Social ecological models integrate multiple levels of influence on health behavior and are noted for emphasizing the interdependence of environmental settings and life domains. This theory-based article explains how social context is conceptualized in the social sciences and how the social science conceptualization differs from and can broaden the analytic approach to health behavior. The authors use qualitative data from the Behavioral Constructs and Culture in Cancer Screening study to illustrate our conceptualization of social context. We conclude that the incorporation into health behavior theory of a multidimensional socioculturally oriented, theoretical approach to social context is critical to understand and redress health disparities in multicultural societies like the United States.

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    • "Contextual aspects can be categorised based on: 1) the immediate social context (family interactions, neighbourhood, and community relationships and support); 2) the contextual realm of institutions and organisations (the structuring of access and barriers to health care and the ability to mobilise resources to get what one needs); and 3) the political, historical and legal realm (historical memories, experiences of migration, discrimination, colonisation, and decolonisation, as well as large-scale demographic, politico-economic, cultural, and historical factors, laws, regulations, and policies) [7]. There is a need to move beyond individual psychological characteristics and contextualise health behaviour in order to provide a more comprehensive understanding of how multiple aspects within migrants’ everyday lives may directly or indirectly affect their participation in mammography screening [7]. "
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    ABSTRACT: Background Lower participation rates in mammography screening are common among migrant women compared to native-born women. Explanations of these lower rates have mainly been based on behavioural theories investigating how lack of knowledge, access to services and culture influence the screening behaviour. The aim of the present study was to contextualise screening behaviour by exploring migrants’ transnational ties and their influence on participation in mammography screening in Denmark. Methods The study is based on the analysis of qualitative interviews with 29 women residing in greater Copenhagen, Denmark and born in Somalia, Turkey, India, Iran, Pakistan and Arab-speaking countries. Results We found that while women had knowledge about breast cancer and mammography screening, it was not prioritised. All women were embedded in transnational ties, which they struggled to retain through emotional and financial obligations, and these current struggles in their everyday life seemed to leave little room for concerns about breast cancer and therefore seemed to contribute to their lower participation in screening. Conclusions The study emphasises the need to take into account the multi-layered and multi-sided factors in migrants’ everyday life in order to further understand their health behaviour.
    BMC Public Health 05/2013; 13(1):431. DOI:10.1186/1471-2458-13-431 · 2.26 Impact Factor
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    • "The stacked Venn design shows overlapping relationships. The levels are formed in relation to and by each other and often influence people in ways of which they are not consciously aware (Burke et al. 2009). The bidirectional arrows indicate the interrelationships among processes and pathways emanating from the different levels that influence the contexts for Aboriginal children's food choices and activity patterns. "
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    ABSTRACT: Obesity prevention efforts in Aboriginal (First Nations, Métis, or Inuit) communities in Canada should focus predominantly on children given their demographic significance and the accelerated time course of occurrence of type 2 diabetes mellitus in the Aboriginal population. A socioecological model to address childhood obesity in Aboriginal populations would focus on the numerous environments at different times in childhood that influence weight status, including prenatal, sociocultural, family, and community environments. Importantly, for Aboriginal children, obesity interventions need to also be situated within the context of a history of colonization and inequities in the social determinants of health. This review therefore advocates for the inclusion of a historical perspective and a life-course approach to obesity prevention in Aboriginal children in addition to developing interventions around the socioecological framework. We emphasize that childhood obesity prevention efforts should focus on promoting maternal health behaviours before and during pregnancy, and on breastfeeding and good infant and child nutrition in the postpartum and early childhood development periods. Ameliorating food insecurity by focusing on improving the sociodemographic risk factors for it, such as increasing income and educational attainment, are essential. More research is required to understand and measure obesogenic Aboriginal environments, to examine how altering specific environments modifies the foods that children eat and the activities that they do, and to examine how restoring and rebuilding cultural continuity in Aboriginal communities modifies the many determinants of obesity. This research needs to be done with the full participation of Aboriginal communities as partners in the research.
    Applied Physiology Nutrition and Metabolism 02/2012; 37(1):1-13. DOI:10.1139/h11-128 · 2.34 Impact Factor
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    • "So, like, I tried to take him bread 'cause when you eat bread it dries up the liquid of the stomach so I gave him some bread, after a while he started drinking again. " DISCUSSION Culture governs social context but it is also appreciably influenced by it [Burke and Joseph et al. 2009]. Moreover, as it is socially constructed, culture contributes to the shaping of an individual's attitudes, perceptions, and behaviors that help them make sense of their world and their behavior choices. "
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    ABSTRACT: The largest proportion of mortality burden for U.S. Latino adolescent males is attributed to motor vehicle crashes. In a traffic safety context, relatively little is known about how these youth regularly interface within their own culture and how developmental factors as well as behavior choices influence their risk of crash injury. This complex sociobehavioral interface has implications for how this group perceives, interprets, and navigates the adolescent period that is coupled with passenger and driver experiences. We conducted a mixed method study with triangulation design inclusive of in-depth ethnically concordant interviews. Purposive sampling was used to select Latino adolescent males (15-18 years old). Validated measures of acculturation, sensation and reward seeking, and threat avoidance were administered. Using a standard discussion guide with prompts, we explored respondents' perceptions of Latino cultural themes, ideas, attitudes, and experiences regarding passenger and driver safety. Codes were created and defined as concepts emerging from the data in an inductive fashion. Using the constant comparative method, we compared coded text to identify novel themes and expand existing themes until thematic saturation was reached. Despite Latino adolescent males expressing a high value of passenger and driver safety, this did not uniformly manifest in their reports of real-life behaviors. Their experiences reflected a dense frequency of exposure to risky behavior modeling and crash injury risk. Opportunities for Latino youth and family-focused risk reduction skill strategies are plentiful. Further research should explore how culture influences parent perceptions of safety and risk and the extent to which family structure shapes the modeling of risk that their adolescent faces.
    Annals of advances in automotive medicine 01/2012; 56:79-86.
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