most of us don’t know what most of us are doing; using social norms theory to prevent injury...
TRANSCRIPT
Most of us don’t know what most of us are doing; Using Social
Norms Theory to prevent injury
SMARTRISK Learning Series
February 20, 2007
Frances Wdowczyk
Dr. Jeff Linkenbach
Ask the question;Are we getting the results that we want with our injury prevention
programs?
Institutional Insanity:
Doing what we have always done in our programs and expecting different
results.
Health Promotion and Injury Prevention
“Just say no”
“Don’t drink and drive”
Versus
“Just do it”
Warning: Bridge Out Ahead!
individual
Assumption of the traditional (individual choice) approach to
prevention:
The social system is working fine and the fault for health problems resides solely with people and their choices.
If the problem is defined as:
• Lack of knowledge = educate
• Disease = provide treatment
• Lack of self esteem = enhance self concept
• Lack of skills = skill building
• Lacking awareness = increase awareness
• Lack of enforcement = tough on crime
Research indicates:
• Programs which focus on increasing individuals’ knowledge, skills, awareness, etc… are successful in increasing these objectives...
• …but they do not necessarily translate into changed social norms for large populations.
Do we have “youth at risk” or do we have youth living in risky
environments?
Teen Pregnancy Data
• In Montana 60% “teen pregnancies” caused by men over the age of 21 (MDHES, 1991).
• Only 1.5 % of all pregnancies in the U.S. and only 8% of all “teen” pregnancies actually involve two minors (children). (U.S. DHHS, 1990).
Environmental Conclusion:
The most important thing adults can do about the “epidemic of teen
pregnancy” in Montana and other states is to stop causing it!
(Kirk Astroth, 1995)
Personal Choice?
Numerous studies indicate that social class is still the single most important
determinant of health with most diseases.
Examples of Environmental Prevention Approaches:
• Laws and Policies.
• Taxes and price increase.
• Density of outlets/ controlling access.
• Hours of operation.
• Events management .
• Increasing enforcement.
In a well designed environmental prevention system, social norms are targeted directly and not just assumed to follow regulations,
laws, enforcement or restricting access.
If 75% of a population are already engaging in healthy
behaviors why do we focus on the 25% who are not?
We must reverse the ratio
The Social Norms Approach
Simple Model of Peer Influence on Personal Drinking & Drug Use
Perception of Peer Influence on Drinking & Drug Use
Research finds: A disparity exists between actual alcohol use by
college students and their perception of other students’
alcohol use.
(* Perkins & Berkowitz, 1988)
Cause of Misperceptions
• Error of attributions (individuals not the environment).
• Failure to contextualize (always extreme).
• Memory & conversation distortions (funny, scary, sickening -- not the mundane).
• Media & advertising distortions (reinforce the misperceptions-- spring break on MTV).
Consequences of Misperceptions
• Self-fulfilling prophesy (reign of error).
• Actual use increases.
• Compounding layers of misperceptions -“I do what you do because it’s what we do.”
• Opposition is discouraged from speaking.
• Intervention by others declines (bi-stander).
• Carriers of misperceptions.
Perceptions of norms are more powerful influences on behavior
than actual norms.
For certain populations it is more important to be normal than to be
healthy!
2003 All Canada Data
• Over-estimate the amount of risky or harmful behaviors in their “peers.”
• Underestimate the amount of healthy or protective behaviors.
Misperceptions Go on and On….
• Actual Norm- 63% of students drink twice a month or less often
• Misperception – 80% of students think students typically drink once per week or more often. One third of students erroneously believe students in general most commonly drink at least 3 times per week
The Social Norms Approach
• Disparity between actual & perceived norms
• Behavior, attitudes, policy support, etc.
• Changed perceptions lead to changed behavior
University of Arizona
Behavior19951997Binge Drink 2wk.43%36%30 day use.75%68%Report DUI35%30%Fight / Argue35%25%Public Misc.38%29%Serious prob.26%23%
2000 2001Wore last time drove 84.9 88.3Wears at least 90% of time 77.6 82.6 *Wore last time as passenger 85.3 91.0 *Always wears as passenger 68.9 75.8 *When passenger last time driver wore 79.5 87.9 *Last time drove made passenger wear 86.6 89.2As driver always makes passenger wear 69 75.1 *Child in restraint seat last time drove 96.1 98.3Was wearing in last accident 71.2 80.3
* Significantly higher at p < .05.
Seat Belt Use by Individuals in Montana
Linkenbach & Associates, 2000
DATA MESSAGE DOSAGE RESULTS
FidelityFidelity
Conferences Meetings
Strategic Planning
Capacity Building
More Focus Groups
Training
Refining Goals
Staffing
Peer Programs
Technical Assistance (T.O.T.)
Advocacy
The Vision:
A cultural environment in which media reflects clear, consistent,
pervasive messages which accurately depict protective measures as the
expected norm for community participation.
“People live with a lot of wrong perceptions, ideas,
and notions, and when they invest their lives in them it
is dangerous.”
Ticht Nhat Hanh