Social Networks & Social Support : Their Role in Public Health

1. Social Networks & Social Support: Their Role in Public Health BinhLe, Dan Dowhower, Bow Lee October 12, 2012

2. The value of understanding social influence • Social influences • Vary by social context • Occurs over the life course • Represent both proximal and distal influences • Act directly and indirectly • Have positive and negative effects on health behavior • Nature of influence • Socialization • Selection • Social norms

3. Structural Characteristics ofSocial Networks and their influence Heany, C. A and Israel. (2008). Social Networks and Social Support. In Health Behavior and Health Education: Theory, Research and Practice; and K. Glanz, B.K. Rimer, and K. Viwanath (Eds). San Francisco CA; Jossey-Bass. pp .189-207.

4. Functional Characteristics of Social Networks and their influence Heany, C. A and Israel. (2008). Social Networks and Social Support. In Health Behavior and Health Education: Theory, Research and Practice ; and K. Glanz, B.K. Rimer, and K. Viwanath (Eds). San Francisco CA; Jossey-Bass. pp .189-207.

5. Upstream and Downstream Factors Lisa F. Berkman, Ph.D.. Cabot Professor of Public Policy and Director, Harvard Center for Population and Development Studies WHO Geneva, June 2-4, 2010

6. Social Influence and TTI • Where in the TTI do the concepts of social network and social support reside? Give examples at each level? • How would you measure the causes of social networks and social support specifically and its relationship to health? • Inner city Chicago versus Corvallis • Which characteristics and functions of social networks would be incorporated? How would they be engaged? How would you influence them?

7. THE THEORY OF TRIADIC INFLUENCE Levels of Causation Ultimate CULTURAL SOCIAL BIOLOGY/ Causes ENVIRONMENT SITUATION PERSONALITY 1 2 3 4 5 6 a f Social/ Personal Nexus c d e b Sense of Information/ Interpersonal Others’ Social Interactions w/ Self/Control Opportunities Bonding Beh & Atts Competence Social Instit’s Distal Influences 7 8 9 10 11 12 g r p i q h k n m l j o Expectancies & Evaluations Self Skills: Motivation Perceived Values/ Knowledge/ Determination Social+General to Comply Norms Evaluations Expectancies 13 14 15 16 17 18 s x ATTITUDES SOCIAL SELF-EFFICACY u w v t Affect and Cognitions TOWARD THE NORMATIVE BEHAVIORAL BEHAVIOR BELIEFS CONTROL Proximal 19 20 21 Predictors Decisions A G B H C I D E F 22 K Experiences 23 Related Behaviors J Intrapersonal Stream Social/Normative Stream Cultural/Attitudinal Stream Biological/Nature Nurture/Cultural DECISIONS/INTENTIONS Trial Behavior EXPERIENCES: Expectancies -- Social Reinforcements -- Psychological/Physiological 6

8. Social Action Theory

9. Social Action Theory (1) • Personal goals and characteristic problem-solving strategies in everyday contexts generate habitual action patterns and persist over time • Theory asks us to consider the importance of • Social interaction • Shared routines • Personal self-regulatory resources • Environmental self-regulatory resources • Problem solving • Outcome expectancies • Self-efficacy

10. Social Action Theory (2) • Habits are vital routines that serve the universal human pursuits of • Health, love and wealth (these are health goals) • Efforts to change health habits are apt to flounder if they thwart or fail to serve these central aims • Remember! Unhealthy habits are functional, disruption causes frustrations and habits are comprised of complex feedback loops • SAT identifies ways in which the environmental structures shape self-regulatory power, and thereby foster the expectations, emotions, self-goals, and routines that enhance or threaten health

11. Phases to health habit change (1) • Phase 1 – select targets for change by defining habits as action sequences and then specifying how these sequences are woven unobtrusively into important daily routines (Action Stage) • Phase 2 – engage habits and identify the forms of proactive awareness (attention, evaluation, cognitive affective) and social engagement (interpersonal orientation, engagement, control) (Self-Change Process)

12. Phases to health habit change (2) • Phase 3 – identify critical regulatory resources need to support self-change processes (Contextual Influence) • Contextual architecture of health protective action – how so we engage this to increase long-term change • Social-emotional competence (mastery of the values, means, and properties of one’s social milieu) • Objective assets, (access to goods, information, services) • Social power (relationships that let one influence others in desired ways)

13. Social Action Theory Model

14. Create a Model for Sexual Risk Behavior

15. SAT Model of Sexual Risk Behavior

16. Social Network Theory

17. What is it? Social Network Theory (SNT) is the relationship of the individual within a social system influences dispositions, and behavior (Berkman, 2000) The belief behind social network theory (SNT) is that individuals are entrenched in thick webs of social relations and interactions Helps explain social order: how autonomous individuals can combine to create enduring, functioning societies Provides explanations for numerous social phenomena, from individual creativity to corporate profitability

18. Social Networks Provide social interaction, communication channels, and reference for making decisions An individual’s location/status within the system is important based on influence Can be narrow or widespread, dynamic or static, homogenous or heterogeneous, transient or stable

19. The Types of Ties in a Network What are some of your social networks and reasons why you are considered part of that network? Borgatti, S.P., et al. (2009). Network analysis in the social science. Science.

20. Interactions Proximal social influences– stems from the interactions with family and friends. They are embedded within other levels of social influence that act both directly and indirectly through proximal others to reinforce social norms.

21. Social Network Video http://www.youtube.com/watch?v=kIMjshoX6rQ

22. Social Networks Understanding that networks can be developed with organized purpose, what are some “groups” that you know that can provide this support? How do they do it? And do you see any consequences of it?

23. Social Networks and Religion Physical health, morbidity, and mortality Mental health and psychological well-being Health behaviors and personal lifestyles Self-esteem and personal efficacy Coping resources and behaviors Positive emotions Healthy beliefs Ellison C.G., & Levin, J.S. (1998). The Religion-health connection: evidence, theory, and future Directions. Health Education and Behavior.

24. The Negative Consequences Passively yielding responsibility for resolving crises entirely up to divine intervention Unproductive or counterproductive religious coping responses Belief in original sin and belief in an omnipotent, omniscient deity may erode self-esteem and divert attention away from productive problem solving or emotion management Social norms and pressures can increase negative consequences of stressors Sources of stress through greed and gossip Perceived support vs. received support Ellison C.G., & Levin, J.S. (1998). The Religion-health connection: evidence, theory, and future Directions. Health Education and Behavior.

25. Social Networks in the 21st Century Social networks in the modern day: Through television, internet and radio. Social networks can be mixed with overt contacts and vicarious information sources. Can you name any social networks you are a part of that are not traditional and not involve proximal contact? Do you see any advantages to this? Any disadvantages? How to do we combine both avenues to strengthen our network?

26. Social Networks and the Theory of Triadic Influence

27. Social Development Model

28. What is the SDM? • Reciprocal Effects-past behaviors shaped present/future behaviors • Transactional-from one person to another • Transformational –developmental stages transform behavior Catalano R.F., & Hawkins, J.D. (1996). The social development model: a theory of antisocial behavior. Delinquency and Crime.

29. Socialization • Perceived opportunities for involvement and interactions with others • The degree of the interaction • Skills to participate in involvement and interaction • Reinforcements (to either be pro- or anti-social) Catalano R.F., & Hawkins, J.D. (1996). The social development model: a theory of antisocial behavior. Delinquency and Crime.

30. Socialization-The Hmong • No perceived opportunities for involvement and interactions with others • The degree of the interaction is very little • Skills to participate in involvement and interaction is non-existence (except for work) • Reinforcements (positive/negative)

31. Social Bonding • Attachment to others • Commitment that is in line with the norms • Values and beliefs Catalano R.F., & Hawkins, J.D. (1996). The social development model: a theory of antisocial behavior. Delinquency and Crime.

32. Social Bonding-The Hmong • High attachment to the Hmong communities • Commitment that is in line with the norms-sexual health is a taboo topic • Values and beliefs

33. Activity Time!

34. Questions/Comments/Discussion