Behavioral Research

Table of Contents
1 General Definition

Use of the Construct in Health Behavior Theories


Measures and Measurements


Similar Constructs


Measurement and Methodological Issues




Measures Appendix

8 Published Examples

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Other Constructs



Dispositional Optimism




Illness Representations

  Implementation Intentions
  Intention, Expectation, and Willingness
  Normative Beliefs
  Optimistic Bias
  Perceived Benefits
  Perceived Control
  Perceived Severity
  Perceived Vulnerability
  Self-Reported Behavior
  Social Influence
  Social Support

Social Influence
Thomas A. Wills, Michael G. Ainette, and Carmella Walker

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Use of the Construct in Health Behavior Theories

Social Modeling Theory. The original version of social learning theory posited that behavior is influenced by modeling processes. In this theory a person observes the behavior of other persons and tends to model that behavior, particularly so if he/she feels a sense of attachment to the others (Bandura, 1977). For example, younger children could acquire healthy vs. unhealthy habits through observing the behavior of their parents (e.g., parental smoking or eating patterns). Evidence has shown correlations for example between parental substance use and children's smoking and alcohol use (Hawkins, Catalano, & Miller, 1992), consistent with a modeling process (though there are other possible mechanisms). From the prevention perspective, this theory suggested that improvements in health-related behavior could be achieved by altering the modeling influence, for example through helping parents to quit smoking or adopt healthier diets (e.g., Loken, Swim, & Mittelmark, 1990).

Social Pressure Theory. A development in social learning theory gave more emphasis to the role of peers, and posited that adoption of a health risk behavior (e.g., trying cigarettes) was influenced by explicit social pressure from peers in group contexts. Here it was suggested that peers might provide offers of cigarettes and then apply social pressure, through taunts or criticism, to teens who did not immediately go along with the offers (Evans, 1984; Evans & Raines, 1990). This model of social factors became the basis for what was termed a social-inoculation approach to prevention, using filmed models to demonstrate assertive responses to social pressure situations, and thereby aiming to increase teens' resistance to peer pressures for unhealthy behaviors (Evans, Rozelle, Mittelmark, Hansen, Bane, & Havis, 1988, Evans, Rozelle, Maxwell, Raines, Dill, Guthrie, Henderson, & Hill, 1991). Evidence has shown peers' substance use to be a direct influence on an adolescent's behavior (Ennett & Bauman, 1994; Wills & Cleary, 1999). The precise mechanism of peer influence remains under debate, because there is some discrepancy between adolescents' reports of peer behavior and the peers' own reports about their behavior (Bauman & Ennett, 1996), and there is little evidence that peer influence occurs through the exertion of explicit pressure on other teens (Kobus, 2003).

Social Norm Theory. While the previous models focused on more direct forms of influence, several models have focused more on individuals' perceptions of social norms about a health behavior. These perceptions, whether accurate or not, can serve as a form of social influence if individuals adopt health-related behaviors that they perceive to be approved by their social reference group. This conception of social influence derives in part from the Theory of Planned Behavior which postulates that perceptions of social norms about a behavior are an important influence on action (Ajzen, 1985, 1991). It is also represented in theories about the impact of social consensus, which suggest that individuals make inferences about the acceptability of a behavior through consulting their perceptions of how prevalent the behavior is in the population (Marks & Miller, 1987). This perception is particularly important for behaviors such as adolescent smoking, because studies show that young persons tend to overestimate the frequency of smoking among teens (Sherman, Presson, Chassin, Corty, & Olshavsky, 1983) and smokers tend to overestimate this even more (Gibbons, Gerrard, & Helwig-Larsen, 1995; Sussman, Dent, Mestel-Rauch, Johnson, Hansen, & Flay, 1988). This conception of social influence has been embedded in prevention programs that aim to reduce smoking initiation through correcting erroneous perceptions of social norms through showing participants real data indicating that relatively few adolescents smoke and the majority of teens have relatively negative norms about smoking and other drug use (Hansen & Graham, 1991). This approach can have advantages because social-inoculation programs tend to have reverse effects with teens who are already smoking (Donaldson, Graham, Piccinin, & Hansen, 1995).

Social Perception Theory. Social-perception models take a somewhat different approach through positing that an individual's perceptions of persons who engage in healthy or unhealthy behaviors can have a motivating effect for their own behavior. For example with adolescent smoking, the basic concept is that if an individual perceives teens who smoke in relatively favorable terms (i.e., popular, attractive) then he/she will be more likely to take up cigarette smoking. One conception of this type of influence posits that smoking initiation occurs through wanting to adopt the social image of the prototype user and hence become more popular/attractive (Gibbons & Gerrard, 1995; Gibbons, Gerrard, & Lane, 2003). Another conception of this type of influence is a desire to identify with a particular subgroup of adolescents ("crowds") who are viewed as socially attractive or influential in the school setting (Mosbach & Leventhal, 1988; Sussman, Dent, McAdams, Stacy, Burton, & Flay, 1994). Even though teens tend to have fairly negative perceptions of users in general, studies show that those who relatively more favorable perceptions of users are more likely to adopt smoking or alcohol use (Blanton, Gibbons, Gerrard, Conger, & Smith, 1997; Chassin, Tetzloff, & Hershey, 1985), and this concept has been extended to behaviors such as contraception and condom use (Blanton, VandenEijnden, Buunk, Gibbons, Gerrard, & Bakker, 2001; Gibbons, Gerrard, & Boney McCoy, 1995). In contrast, relatively favorable perceptions of abstainers have been shown to have a protective effect with regard to substance use and sexual risk behavior (Gerrard, Gibbons, Reis-Bergan, Trudeau, Vande Lune, & Buunk, 2002; Wills, Gibbons, Gerrard, Murry, & Brody, 2003). Because social perceptions are malleable, intervention programs have used the approach of modifying social images in a healthier direction in order to deter early onset of smoking and alcohol use (Brody, Murry, Gerrard, Gibbons, Molgaard, McNair, Brown, Wills, Spoth, Luo, Chen, & Neubaum-Carlan, 2004; Gerrard, Gibbons, & Gano, 2003; Gerrard, Gibbons, Brody, Murry, Cleveland, & Wills, 2006).

Social Communication Theory. Communication models consider how discussions between parents and children are focused to directly communicate parental norms and values about health-related behavior. It is known that parental norms about substance use by teens (which tend to be fairly negative) are related to adolescents' behavior, and communication models have generated evidence showing that frequency of parent-child communication about the behaviors is related to rates of adolescent substance use and sexual risk taking (Brody, Flor, Hollett-Wright, & McCoy, 1998; Whitaker & Miller, 2000; Wills et al., 2003). Intervention models have used this conception of social influence to design educational components to stimulate parent-child discussion about health behaviors and provide guidelines to parents on how to communicate their norms and values about these topics (Brody, Murry, Gerrard, Gibbons, McNair, Brown, Wills, Molgaard, Spoth, Luo, & Chen, 2006; Spoth, Redmond, & Shin, 1999).

Media Exposure Theory. A recent development in social influence theory is studies that consider how exposure to cues in mass media (television, movies, or print advertising) affects viewers' attitudes and intentions about health behaviors. With a focus on adolescents, there is accumulated evidence that tobacco advertising and marketing strategies could influence teens' behavior through portraying smoking as attractive, and possibly weight-reducing (Pierce, Lee, & Gilpin, 1994). This research was based on a variant of modeling theory, positing that frequent exposure to cues showing smoking in exciting and pleasurable situations, and associated with attractive or unconventional characters, would lead to more favorable attitudes toward smoking (DiFranza, Richards, Paulman, Wolf-Gillespie, Fletcher, Jaffe, & Murray, 1991; Evans, Farkas, Gilpin, Berry, & Pierce, 1995). Recent studies have found that movie exposure to smoking by actors is related to smoking initiation among adolescents, so there is evidence of an influence on smoking behavior (Distefan, Pierce, & Gilpin, 2004; Sargent, Beach, Dalton, Mott, Tickle, Ahrens, & Heatherton, 2001). The exact mechanism through which this effect occurs has not been established at present; it may involve some combination of cognitive/attitudinal changes or effects on affiliation with substance-using peers (Sargent, Wills, Stoolmiller, Gibson, & Gibbons, 2006). The implications of these findings for preventive intervention have been explored in several projects with mass media programs designed to deter teen smoking or alcohol use (Donohew, Lorch, & Palmgreen, 1991; Sargent, Dalton, Heatherton, & Beach, 2003; Wakefield, Flay, Nichter, & Giovino, 2003).

Neighborhood Context Theory. Environmental theories have added another dimension to health behavior theory through considering the influence of larger social contexts. In this conception, the attributes of larger social units such as neighborhoods may have an influence on behavior, above and beyond the impact of factors impinging on a person from his/her immediate social context of family and friends (Leventhal & Brooks-Gunn, 2000). It has been hypothesized that adoption of unhealthy behavior may be influenced by neighborhood variables including the overall level of poverty and residential instability, and the prevalence of crime and aggressive behavior (Hawkins et al., 1992; Petraitis, Flay, & Miller, 1995; Wills, Pierce, & Evans, 1996). Conversely, factors that help to bind a community together, such as social trust and civic engagement, can serve as protective factors (Kawachi, Kennedy, Lochner, & Prothrow-Stith, 1997). Research on neighborhood factors and health behavior are still emerging but recent studies have shown that environmental factors are related to smoking behavior (Diez-Roux, Merkin, Hannan, Jacobs, & Kiefe, 2003; Novak & Clayton, 2001) and that family and peer risk factors have more effect on adolescent substance in adverse environments (Gibbons, Gerrard, Cleveland, Wills, & Brody, 2004). The implications of this theoretical approach are beginning to be explored but suggest that approaches such as neighborhood policing, economic development, and modifications to the built environment may have an impact on health status.

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