Conceptual Model Building -101 November 2018 Overview

 Introduction to Health Behavior Theory  Basics of designing a theory-informed conceptual model to better understand health behavior

 Understanding the link between a theory-informed conceptual model and a logic model Part 1. Introduction to Health Behavior Theory What health behaviors help to prevent chronic disease? What factors facilitate these health behaviors? What factors prevent these health behaviors? As you can see…there are many factors that influence behavior.

So, where do you start? Social Ecological Model

CDC’s version of Social Ecological Model Ecological Model of Predictors of Childhood Overweight Community, demographic, and societal characteristics

Ethnicity Socioeconomic Parenting styles and status family characteristics School foods& Child feeding Peer and sibling drinks practices interactions Child characteristics Crime rates and Types of foods and child risk factors Family TV neighborhood available in the viewing safety Gender Age home Parent CHILD monitoring of Work hours Nutritional DIETARY WEIGHT SEDENTARY child TV knowledge INTAKE STATUS BEHAVIOR viewing

Knowledge & School PHYSICAL Parent preference physical Parent dietary Attitudes Familial ACTIVITY for activity education intake susceptibility to program weight gain Parent activity Leisure time Parent food patterns preferences Parent Parent weight encouragement of status child activity Accessibility of Family leisure recreational time activity facilities Accessibility of convenience Adapted from: Davison & Birch. foods and restaurants 2001 Decision-Oriented Theories Underlying Psychology

Core Insight - Behavior is determined by perceptions of costs and benefits that would occur if one performed the behavior

-HBM and other theories differ in how they calculate the benefits and the costs

Modifications -Behavior is determined by perceptions of costs and benefits if one performed the behavior and about ability to perform the behavior. Health Belief Model Modifying Factors Likelihood of Action

Age, sex, ethnicity Perceived benefits minus Individual Perceptions Personality Socioeconomics Perceived barriers to Knowledge Behavior change

Perceived Susceptibility & Perceived Threat Likelihood of Behavior Severity of Disease of Disease Change

Cues to Action -Education -Symptoms Self-efficacy -Media

*Self-efficacy added in 1988 Theory of Planned Behavior

Behavioral Beliefs Attitude toward behavior Evaluation of Behavioral Outcomes Behavioral Intention Behavioral

Normative Beliefs Subjective Norm

Motivation to Comply

Control Belief Perceived Behavioral Control Perceived Power Stage Theories Transtheoretical Model Interpersonal Theories Social Influence Influence

Person

Social Context Social Networking

Person in Person 6 Network (Alter) Person 2

Focus Individual (Ego)

Person 3

Person 5 Person 4 Built Environment & Environmental Justice Community and Health

 Community-Based Participatory Research  Community Empowerment and Activism  Collective Efficacy  Coalition Building Framework for studying community and health

Political and Policy Economic Systems Cultural Systems Systems & Prosperity

Community/Social Environment Community/Physical Environment -Poverty -Pollution -Gender/Inequality -Population density -Social cohesion -Climate -Cultural norms

Community Responses -Community activation -Community social support

Community Outcomes -Social Behaviors Society & Health, 1995 Pg 67. -Community health and QOL Part II. Basics of designing a theory- informed conceptual model to better understand health behavior Developing a conceptual model for health behavior change intervention  Identify your population and behavior  Identify risk and protective factor data  Conduct formative work – know your population  Obtain evidence to support your potential change agents  Identify your theory-informed constructs  Develop pathways for your conceptual model  Overlay your conceptual model – intervention  Map your conceptual model – Evaluation plan http://www.sprc.org/library/phasp.pdf “My Baby, My Move” A Perinatal Physical Activity Intervention

Process Outcomes

Inputs Activities Short-term and Intermediate Long-term and Impact Outcomes Outcomes

Resources Build Partnerships -Funding -Create collaborations Increase Increase Decrease Decrease mental -Program -Identify community physical activity postpartum health disorders Staff panel members knowledge depression (e.g. depression, and co-morbid Develop Increase physical Decrease Decrease anxiety) Guidance/ Intervention antenatal adverse birth Training -Facilitate focus groups activity self- weight gain outcomes Improve child -Mentorship -Conduct informant efficacy developmental -Didactic interviews Decrease Decrease and behavioral trainings -Survey assessment Increase antenatal maternal outcomes -Workshops -Develop Manual of Self-regulation depression postpartum Procedures overweight Decrease Increase social Decrease overweight and Implement Physical Collaborations support perceived obesity -Universities Activity stress - Hospitals, Clinics Intervention -Community -Test recruitment Organizations strategies -Train staff -Develop resources Part III. Understanding the link between a theory-informed conceptual model and a logic model. INPUTS OUTPUTS OUTCOMES

Program Long- Activities Participation Short Medium investments term

What we What Who we What results invest we do reach

Adapted from http://www.uwex.edu/ces/pdande/evaluation/evallogicmodel.html “My Baby, My Move” A Perinatal Physical Activity Intervention

Process Outcomes

Inputs Outputs Short-term and Intermediate Long-term and Impact Outcomes Activities Outcomes Resources Build Partnerships -Funding -Create collaborations Increase Increase Decrease Decrease mental -Program -Identify community physical activity postpartum health disorders Staff panel members physical activity self- depression (e.g. depression, efficacy and co-morbid Develop Decrease Decrease anxiety) Guidance/ Intervention antenatal adverse birth Training -Facilitate focus groups Increase weight gain outcomes Improve child -Mentorship -Conduct informant Behavioral developmental -Didactic interviews Skills Decrease Decrease and behavioral trainings -Survey assessment antenatal maternal outcomes -Workshops -Develop Manual of Increase social depression postpartum Procedures support overweight Decrease Decrease overweight and Implement Physical Collaborations perceived obesity -Universities Activity stress - Hospitals, Clinics Intervention -Community -Test recruitment Organizations strategies -Train staff -Develop resources Logic model in evaluation

Adapted from http://www.uwex.edu/ces/pdande/evaluation/evallogicmodel.html  “The gift of theory is that it provides the conceptual underpinnings to well-crafted research and informed practice.”

- Glanz et al. 5th Ed Questions?

Contact Information:

Jenn Leiferman, PhD

Associate Professor

Director, Rocky Mountain Prevention Research Center

Director, Population Mental Health & Wellbeing Program

Colorado School of Public Health https://www.populationmentalhealth.org [email protected]