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Division of Health Promotion, Graduate School of Public Health College of Health and Human Services, San Diego State University PH 661 Theoretical Foundations of Health Promotion Fall 2013 Class Schedule: Wednesdays, 10:00-12:40pm HT 183 Office hours: Office: HH 114E Wednesdays 1:30-3:30pm. If you are not able to make it during my office hours or need to meet the week I do not have them, we can set up an individual appointment in my Sky Park office. Instructor: Elva M. Arredondo, PhD Associate Professor, Division of Health Promotion San Diego State University, Graduate School of Public Health Primary telephone at BACH (Sky Park): 619-594-3481 Fax number: 619-594-2998 [email protected] Teaching Assistant Emily Schmied, MPH [email protected] Course Description & Goals Through interactive lectures, discussions of readings and case studies, the course will cover the theoretical underpinnings of health behavior and health promotion strategies. Factors related to the initiation, maintenance, and change of health behaviors will be reviewed in depth, and application of these principles to health promotion with individuals, groups and communities will be presented. Students will apply this knowledge to a specific health topic of interest, and in collaboration with group members, will provide a synthesized theoretical perspective on the health topic using the socio-ecologic framework. Each group will share their findings to the class in 15 minute presentations, along with an integrated paper, at the end of the course. Course Objectives & Teaching Methods The course is designed around three objectives and corresponding teaching and evaluation methods. Objectives Name and describe a selected set of widely employed behavioral and social science (B/SS) theories /models /constructs/principles used to develop or improve programs to reduce or eliminate major public health problems Identify the assumptions underlying these theories /models /constructs/principles, and have a basic understanding of the types of health problems, settings, populations, and cultures in which they have been used. Varied Teaching methods Interactive lectures Discussions of readings Case studies Interactive lectures Discussions of readings Case studies Evaluation methods Class participation Exams Use B/SS theories/models/constructs/principles to analyze a public health problem in terms of known/probable causes and to identify possible intervention opportunities. Critically analyze major strengths and limitations in using B/SS theories/models/constructs/principles for planning/improving HPDP programs and their implementation. Discussion of readings Class participation Exams Individual paper Group presentations Individual paper Group presentation 1 Evaluation Methods Your performance in the course will be evaluated on the following assignments: 1. Midterm Exams 1 and 2 You will have two closed-book, in-class mid-term exams (see schedule). These exams are not cumulative, and will consist of multiple choice, short-answer and discussion questions, covering both lecture material and readings. 20 pts & 20 pts Students who believe that they have provided a correct answer and failed to receive adequate credit are required to prepare a two page typed explanation for each test item within one week of receipt of the exam grade. Credit will be provided for those written explanations that are judged correct. 2. Description of paper and 5 references 3. Abstraction 4. Individual paper 5. Feedback to other students about paper 6. Thesis topic exploration 7. Group presentation 8. Participation Total 5 pts 5 pts 15 pts 5 pts 10 pts 15 pts 5 pts 100 Extra credit (3 points added): Course grades will be assigned as follows based on total points accumulated for the semester: A AB+ B B- 96-100 90-95 87-89 84-86 80-83 C+ C CF 77-79 74-76 70-73 <70 Incomplete: Medical emergencies verified by practicing clinicians and limited other emergencies are the basis for an incomplete. Course Attendance Policy: Although attendance is not mandatory, students are encouraged to attend all classes. Participation in classroom activities will serve as a record for attendance and the latter will be used as one method for generating the participation grade for the course. Absences for religious observances: By the end of the second week of classes, students should notify the instructor of planned absences for religious observances. The instructor will provide appropriate accommodations. Readings and Course Materials Required Textbook: Glanz, K., Rimer, B. K., & Viswanath, K. (2008). Health behavior and health education: Theory, research, and practice (4rd ed.). San Francisco, CA: Jossey Bass. Additional required readings and other resources: The articles that you will be asked to review will allow you to better understand how these theories are being used in the field of public health. Some articles are older as they represent CLASSIC references that you should know about. All articles are posted on blackboard: blackboard.sdsu.edu. 2 Other Administrative Issues Academic Integrity Academic dishonesty is an affront to the integrity of scholarship at SDSU and a threat to the quality of learning. Violations of academic integrity are noted in the SDSU Statement of Student Rights and Responsibilities: 2.1 Cheating shall be defined as the act of obtaining or attempting to obtain credit for academic work by the use of dishonest, deceptive, or fraudulent means. Examples of cheating include, but are not limited to (a) copying, in part or in whole, from another’s test or other examination; (b) discussing answers or ideas relating to the answers on a test or other examination without the permission of the instructor; (c) obtaining copies of a test, an examination, or other course material without the permission of the instructor; (d) using notes, cheat sheets, or other devices considered inappropriate under the prescribed testing condition; (e) collaborating with another or others in work to be presented without the permission of the instructor; (f) falsifying records, laboratory work, or other course data; (g) submitting work previously presented in another course, if contrary to the rules of the course; (h) altering or interfering with the grading procedures; (i) plagiarizing, as defined; and (j) knowingly and intentionally assisting another student in any of the above. 2.2 Plagiarism shall be defined as the act of incorporating ideas, words, or specific substance of another, whether purchased, borrowed, or otherwise obtained, and submitting same to the University as one’s own work to fulfill academic requirements without giving credit to the appropriate source. Plagiarism shall include but not be limited to (a) submitting work, either in part or in whole, completed by another; (b) omitting footnotes for ideas, statements, facts, or conclusions that belong to another; (c) omitting quotation marks when quoting directly from another, whether it be a paragraph, sentence, or part thereof; (d) close and lengthy paraphrasing of the writings of another; (e) submitting another person’s artistic works, such as musical compositions, photographs, paintings, drawings, or sculptures; and (f) submitting as one’s own work papers purchased from research companies. 3.0 Academic and Punitive Sanctions: Cheating and plagiarism in connection with the academic program at The University may warrant two separate and distinct courses of disciplinary action that may be applied concurrently in response to a violation of this policy: (a) academic sanctions, such as grade modifications; and (b) punitive sanctions, such as probation, suspension, or expulsion. Other issues All assignments must be typed using Microsoft Word or a similar word processing program. In addition to spelling, grammar, and writing style, your work will be evaluated based on professional appearance (examples of non-professional appearance: crinkled pages, stains, poor staple job) Electronic versions of your assignments should be placed in the “drop box” in Blackboard. You are strongly encouraged to keep computer backups of your work to avoid losing information and time. No late or make-up assignments will be accepted. All assignments are due in hard copy at the beginning of class. If you are unable to attend class on the day an assignment is due, have someone bring the assignment to class for you or leave it in my GSPH mailbox BEFORE 1:00pm of the due date. No assignments will be accepted via email. If you have an Authorization for Accommodations form that indicates a need for academic accommodations, please let me know so we can discuss this. Student Disability Services is located in Calpulli Center, Suite 3100 (third floor), (619) 594-6473 and (619) 594-2929 (TDD/TTY) Cell phones and beepers should be turned off during class time; there will be no laptop computers open during lectures; you may use your laptop during group discussions. 3 The course schedule was created considering the breadth of information available for us to review, the number of weeks available to cover this content, and other factors competing with our schedules (your other classes; holidays, etc). Thus, we are likely to modify this a bit as we progress through the semester. Outline of Course Week 1 Date Aug. 28 2 Sept. 4 3 Sept. 11 4 Sept. 18 5 Sept. 25 6 7 Oct 2 Oct. 9 8 Oct. 16 9 Oct. 23 10 Oct. 30 11 12 13 14 15 16 Content Introduction to course Theory in research, practice, and service Ecological perspective to health Individual level Health Belief Model Operant and Classical Conditioning (Dr. John Elder) Individual level (Emily Schmied) Theory of Reasoned Action Theory of Planned Behavior Individual level (Dr. Karen Calfas) Transtheoretical Model Classroom Activity Depict your theory of health with words and diagrams Case study Assignments due Library visit- LA76 (basement of library) for the first part (10am) Case study Case study Midterm Exam 1 Interpersonal level Social Cognitive Theory Interpersonal level (Dr. Holly Baker Shakya) Social networks/influence Community (Drs. Guadalupe X. Ayala & Mel Hovell) Structural models of change Behavioral Ecological Model Behavioral taxonomy (Gina Merchant, Jen Sanchez, Emily Schmied) No activity Case study Nov. 6 Organizational Chronic Care Model (Dr. Greg Talavera) Nov. 13 Nov. 20 Nov. 27 Dec. 4 Dec. 11 Midterm Exam 2 No class—work on paper No class—happy thanksgiving! Group presentations Group presentations Last day of classes Library visit- LA76 (basement of library) for the second part (11:30am) No activity No activity No activity No activity No activity One paragraph description of individual paper plus 5 references due (see guidelines) Abstraction table due Case study Work on presentation Work on presentations 1st draft of paper (bring copies to give to two group members) Give written feedback to classmates Final individual paper due Thesis paper due Other resources: The National Cancer Institute has a website that provides definitions of major health behavior constructs used in research in public health, health communications, nursing and health psychology, common measures used to assess these constructs, and descriptions of the constructs’ theoretical backgrounds (http://cancercontrol.cancer.gov/brp/constructs/aboutproject.html) Another resource is printed in the following booklet: http://www.cancer.gov/PDF/481f5d53-63df-41bc-bfaf-5aa48ee1da4d/TAAG3.pdf 4 Discipline-specific Competencies (Excerpted from the ASPH competencies document; see Blackboard for full document) SOCIAL AND BEHAVIORAL SCIENCES The social and behavioral sciences in public health address the behavioral, social and cultural factors related to individual and population health and health disparities over the life course. Research and practice in this area contributes to the development, administration and evaluation of programs and policies in public health and health services to promote and sustain healthy environments and healthy lives for individuals and populations. Competencies: Upon graduation a student with an MPH should be able to… 1. Identify basic theories, concepts and models from a range of social and behavioral disciplines that are used in public health research and practice. 2. Identify the causes of social and behavioral factors that affect the health of individuals and populations. 3. Identify individual, organizational and community concerns, assets, resources and deficits for social and behavioral science interventions. 4. Identify critical stakeholders for the planning, implementation and evaluation of public health programs, policies and interventions. 5. Describe steps and procedures for the planning, implementation and evaluation of public health programs, policies and interventions. 6. Describe the role of social and community factors in both the onset and solution of public health problems. 7. Describe the merits of social and behavioral science interventions and policies. 8. Apply evidence-based approaches in the development and evaluation of social and behavioral science interventions. 9. Apply ethical principles to public health program planning, implementation and evaluation. 10. Specify multiple targets and levels of intervention for social and behavioral science programs and/or policies. 5 PH 661, Fall 2013 Class Assignments Overall Objective: Integrate existing and new knowledge and skills in health promotion theory in a health topic of interest, and combine this with information from other students using the socio-ecological framework. The Methods: You will be assigned to one of several groups based on your identified health topic preferences. Individually, you will work on several assignments that will compliment each other and inform development of the final group presentation and paper. Assignments 1. Description of paper and 5 scientific references 2. Abstraction table due 3. 1st Draft of individual paper due 4. Feedback to students 5. Final individual paper due 6. Thesis topic paper 7. Group presentation Due Date Sept. 25th October 9th October 30th November 6th December 6th December 11th Extra credit: 3 page paper describing why theory is important in health promotion. Details of Methods The purpose of this assignment is to help you not procrastinate and to begin 1. Description of paper and at least 5 determining whether there is sufficient information in the literature to support your research question. You feel better about your final product the more time references Points: 5 points 2. Abstraction table Points: 5 points 3.&5.Individual paper Points: 15 points you mull over the issues and put your ideas on paper. SEE BELOW UNDER INDIVIDUAL PAPER Your description is limited to 250 words, 12 pt font size, typed double spaced with 1 inch margins. Your references must be formatted in APA or AMA manual of style. Please see Blackboard site for guidelines or obtain a copy of the reference guides in the library. Descriptions that do not adhere to these guidelines will be returned ungraded. The purpose of this assignment is to help you learn how to critically evaluate the application of your theory in your health topic. You are expected to complete the grid for at least 5 papers that describe the application of your theory(ies) in your selected health topic. See grid for information about what to include in your synthesis. Content Each student will prepare a 5 page paper demonstrating the application of a theory or theories to his/her health topic. This assignment will eventually fold into the group presentation wherein group members will demonstrate the application of a theory or set of theories at one level of the socio-ecologic framework across various health topics. Here is an example: Transtheoretical Model Group member 1: Application of TTM in adolescent condom use Group member 2: Application of TTM in childhood obesity prevention Group member 3: Application of TTM in smoking cessation 6 4.Constructive feedback to other students of their paper Points: 5 points 6.Thesis topic paper Points: 10 points 7.Group presentation Points: 15 points Format o 5 pages excluding 150-word abstract and references o A minimum of 10 scientific references o 1-inch margins, 12-point font (preferably Times-New Roman) o APA or AMA-style formatting for paper sections and references in the text and reference section o Papers that do not adhere to these guidelines will be returned ungraded. Criteria o Are the investigators applying the theory properly (based on Noar and Zimmerman’s critique)? Did they apply all of the constructs? Possible reasons for not including all of the constructs? Should have they used all of them? o Are they testing a theory? If so, are they examining all of the constructs of the theory? Why or why not? o If you are reviewing a topic that has limited studies applying the theory, discuss how you would apply a particular theory. o If you are reviewing an intervention, are the authors using the theory to inform the intervention and applying it? o Do NOT spend much time discussing the findings of the studies reviewed o The first two paragraphs should describe the theory and the rest of the paper should be a critique. o No two people should evaluate the same theory and health topic unless approved by the instructor o Review only scientific studies (no reviews) Write a one page, single spaced paper that outlines the strengths and limitations of the paper (it can be bulleted). When you evaluate these aspects, please consider the following: Is the student taking into account the criteria above? Is the paper well written? Does the student provide clear examples? Is the statement backed with justification? Also, consider offering guidance for where the student might find resources and ask for more information on a point that is not clear. Bring two copies for the students to review; no need to upload your feedback in blackboard. Meet with 2 faculty members/organizational leaders/staff to discuss the possibility of doing a thesis with their project (or independently). Write a one page paper describing the following: 1) who you met/talked with (date), 2) possible thesis opportunities, and 3) plan to follow up. You should meet/discuss this with your academic advisor. At the bottom of the page, write 2-3 sentences describing the thesis plan that you are likely to pursue and the theory you are considering (and why). Each group will prepare a powerpoint presentation outlining what they learned about the theory(ies) from the various perspectives. Presentations will occur on the last few days of class. The format will be to briefly introduce the theory (1-2min), how it was applied to each of the health topics, strengths and limitations to how it was applied, is the theory appropriate for your health topic and population (why or why not?). Additional details will be provided over the course of the semester. The group presentations will be approximately 20 minutes each. 7 Note: Please read the articles and chapters prior to coming to class. Some of the readings may change from this list, but the final set will be posted in blackboard the week prior to when they are due. Wk 1 Date Aug. 28 Content Introduction to course Theory in research, practice, and service Ecological perspective to health 2 Sept. 4 Individual level Health Belief Model 3 Sept. 11 Operant and Classical Conditioning (Dr. John Elder) 4 Sept. 18 Individual level (Emily Schmidt) Theory of Reasoned Action Theory of Planned Behavior 5 Sept. 25 Individual level (Dr. Karen Calfas) Transtheoretical Model 6 7 Oct 2 Oct. 9 Midterm Exam 1 Interpersonal level Social Cognitive Theory 8 Oct. 16 Interpersonal level (Dr. Holly Baker Shakya) Social networks/influence 9 Oct. 23 10 Oct. 30 Community (Drs. Guadalupe X. Ayala & Mel Hovell) Structural models of change Behavioral Ecological Model Behavioral taxonomy (Gina Merchant, Jen Sanchez, Emily Schmied) 11 Nov. 6 Organizational (Dr. Greg Talavera) Chronic Care Model Readings You can read them after class Chapter 1 in Glanz Health Behavior Theory and Intervention research by Jeffrey, 2004 Health Behavior Theory and cumulative knowledge by Noar and Zimmerman., 2005 Chapter 3 in Glanz Health Belief Model in Cervical Cancer Screening by Johnson et al., 2008 HBM on the heart failure readmission rates in persons with heart failure, by Sethares et al., 2004 Operant Methods : Nemeroff & Karoly, 1991 Changing Individual Behavior: Elder et al., 1994 Epstein et al., 2004 Positive reinforcement handout Chapter 4 in Glanz Application of TPB to sorority alcohol consumption by Huchting et al., 2008 TPB measurement handout Application of TPB: Ezendam et al., 2007 Chapter 5 in Glanz Validating stage of change measures for PA by Robinson et al., 2008 Transtheoretical Model in Substance Use by Migneault et al., 2005 12 13 14 15 16 Nov. 13 Nov. 20 Nov. 27 Dec. 4 Dec. 11 Chapter 8 in Glanz Daughters and mothers exercising together by Ransdell et al., 2001 Rovniak et al., 2005 Chapter 9 in Glanz Book chapter by Berkman & Glass Social support and patient adherence by DiMatteo Critique of social relationship and health research by Cohen, 2004 Chapter 20 in Glanz Elder, 2007 Cohen, 2000 Michie, Johnston, Francis, et al., Michie & Prestwich (2010) Cane, O'Connor, & Michie (2012) Introduction to the Chronic Care Model: Bodenheimer et al (2 articles) Application of Chronic Care Model interventions by Wagner Midterm Exam 2 No class—work on paper No class—happy thanksgiving! Group presentations Group presentations 8