Download Division of Health Promotion, Graduate School of Public Health

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