Download PRECEDE-PROCEED INTRODUCTION

Chapter 6
Social, Cultural, and
Environmental Theories
(Part II)
Communication...who says what in
which channel to whom and with
what effect..
COMMUNICATION THEORY

Communication is the production and exchange of information by use of signs and
symbols. The processes involved include encoding, transmission, reception
(decoding) and synthesis of information and meaning (Gerbner).

Political theorist Harold Laswell argued that key components of communication
include:
The sender (encodes/transmits)
The message
The receiver (decodes the
information, acts on it)
“Let’s have dinner tonight”
The channel
The effect =
COMMUNICATION THEORY

Other factors affecting the communication
process include:
 Context of the communication (e.g.,
formal, informal)
 Relationship between sender and receiver
 The meaning attached to the channel
(e.g., Wall Street Journal vs. gossip)
 The process of encoding and decoding
itself
COMMUNICATION AS A CODE

What do we mean by that?
 When you as a speaker send a message to another person
or a group of people, what do you do? Do you simply utter a
string of information?
 NO…you put the information into a CODE that will make
sense to the intended recipient. [Advertisers are experts at
encoding information. In a NIKE commercial with Michael
Jordan wearing the “Air Jordan” shoes, what message is
ENCODED?
 When the message gets to the recipient, the recipient
DECODES it to interpret its meaning(s).
 Why is important to CODE messages appropriately?
COMMUNICATION THEORY,
CONT’D

What is a communication channel?
 Is the MEDIUM through which you transmit the
information: newspapers, TV, video, internet, interpersonal
communication, rallies, etc.
 Channels can also be more specific, like Hispanic
newspapers, or college radio, or thru churches, etc.

The use of media and communications in public health aims
to provide information, influence behavior change, and impact
the AGENDA of what people are concerned about, in order to
set the stage for action.
THINGS TO THINK /
CRITIQUES

It is sometimes complicated and difficult to assess the
impact of a communications effort. Why? Because there
are many levels of possible impact:


Simple exposure – how many of the intended audience
were exposed to the message?
How many of those exposed will make the behavior
change?
COMMUNITY AND
ORGANIZATIONAL CHANGE


In many situations, change in the health behavior of
individuals first requires change in the community itself, in
norms, laws, physical conditions, systems, or organizations
relevant to the situation.
Communities, organizations and systems can either support
or inhibit health behavior change.
You can not expect people to
engage in HIV preventive
behavior if the community
exerts strong pressures on
individuals NOT to discuss or
even admit to any risk for the
disease.
COMMUNITY MOBILIZATION




Community mobilization efforts involve collective action by
groups and community members to increase awareness
about the problem, advocate for policy change, and engage in
other activities to address the ecology of a health problem.
Empowerment means that the community takes charge of the
issue, defines what the goals are, and takes the necessary
action.
By doing that, the community gains experience and sense of
efficacy about resolving local problems.
KEY issues in mobilizing communities:



Defining the community.
Assessing and working with the community’s capacity for
mobilizing.
Understanding the community agenda and selecting the
right issue.
ORGANIZATIONAL AND
SYSTEMS CHANGE


Organizational development (OD) is both a philosophy and an
approach to organizational change that view organizations as
systems of human beings.
Organizational change improves the capability of
organizations and systems to respond to health issues
through a change process that focuses on;
 Assessing and improving group dynamics within the
organization/system (the way people work together).
 Encouraging shared goals and missions.
 Identifying organizational impediments to change, and
“unfreezing” the organization or system to make changes.
 Involving the organization or system in identifying and
implementing new policies and practices.
POLITICAL ECONOMY AND
HEALTH




Think about health problems as products of a larger set
of social relationships, particularly relationships of
socioeconomic structure, class, ethnicity and gender.
A health problem (and co-occurring health problems)
can be seen as part of a trajectory of risk or trajectory of
exposure shaped by the larger social relationships in
which exists.
Under this approach, solutions must address the social
relationships (e.g., economic patterns, relationships of
ethnicity, etc) that contribute to the problem.
Example: Why has HIV/AIDS in the U.S. had a such a
disproportionate effect on poor, minority urban
communities? How does that setting impact the
problem?
ANTHROPOLOGY AND
CULTURAL THEORY



Biological anthropology focuses on health behavior as a
species adaptation to (or interaction with) an
environment.
Cultural anthropology understands and explains health
behavior as part of a pattern of living that integrates
action with meaning, symbols, and values, as these are
connected to a larger social structure. In other words,
behavior cannot be separated from its larger context.
Example: Use of health care services (a behavior) in an
urban immigrant community may be an outcome of
integrated factors: language barriers, economic
resources (to pay for care), beliefs about the nature,
cause and treatment of illness (culture), social
hierarchies in the community, etc.