Sociology and Psychology in Public

Health

By: Adam Izzeldin, BPEH, MPHDepartment of International Health, TMDU.

Myfanwy Morgan, Margaret Reid, Jane Ogden. Oxford Textbook of Public Health.

introduction Sociology and psychology in public health Theories of sociology and psychology Sociological and psychology methods,

investigations and interventions. Developing interventions to change health-

related behaviour and; Conclusion

Key components

Introduction

Sociology and psychology share a number of common interests and areas of study in the public health field:

issues relating to the psychosocial environment as causes of disease, helpseeking behaviours and adherence with treatment.

issues relating to ageing and disability, as well as effective health promotion interventions and the measurement of health status and quality of life.

settings of psychology and sociology

History of medical sociology

The period of rapid growth of medical sociology began in the 1950s in the United States and about a decade later in the United Kingdom.

The founding of an international journal, Social Science and Medicine, which forms a marker in the development of the discipline, occurred in 1966.

shared interests between sociology and public health

The adoption of public health to social model of the causes of ill health and appropriate interventions (many health problems as social and environmental rather than individual-healthy public policy).

The move towards a more social and participative model of healthcare was also encouraged by broader changes in society.

 Integration between sociology and public health

Indeed it is increasingly difficult to determine precise disciplinary boundaries, as sociology, psychology, and public health medicine

Sociologists are now likely to team up with other social scientists, for example, anthropologists and social geographers, as well as with medical public health specialists, to address public health problems (integrated team)

Structural theories

Regard society as constraining and shaping the beliefs, values, and patterns of behaviour of social groups

Functionalist theory proposed a view of society in which the various parts worked together fairly harmoniously .

Parsons identified illness as dysfunctional for the smooth running of society because he argued that sick people are not able to fulfill their normal social role

Social action theories

to understand subjective meanings, with social action forming a product of how individuals interpret the world and interact with others on the basis of these meanings.

comprise different theoretical positions, most notably those of symbolic interactionism, phenomenology, ethnomethodology, and social constructionism

Sociological methodsQuantitative Qualitative

View of the world

Social reality exists as objective, measurable phenomena, external to the individual (positivism)

Social reality is subjectivelyinterpreted and experienced(interpretive)

Logic of enquiry

Deductive based on testing formal hypotheses to establish causal relationships

Inductive reasoning withunderstanding of socialprocesses derived from data

Researchdesign

Quantitative, with sampleselection, data collection, and analyses based on scientific procedures and ensuring repeatability and generalizable results

Qualitative, based on detailed study of social processes of groups of interest to elicit interpretations and responses

Validity Corresponds to an objective reality Corresponds to subjectivereality; other terms include trustworthiness credibility, plausibility

Research designs in sociology

Ethnography: observing the social structure and local culture of small groups

Participatory action research (PAR) and user involvement: participatory, democracy and its contribution for science and local change.

Mixed methods: quantitative and qualitative approaches to achieve a broader understanding and avoid weakness

Areas of sociological investigation

Examples for applications of social interventions

Meanings and identity Biographical disruption Suffering and loss of self Adaptation and self-management Sociology and place Food choices and physical exercise Social capital

Psychology in public health

Psychological theories recently focus on mental health through the work of clinical psychologists and their interest in problems such as anxiety, depression, psychosis, and phobias.

The role of psychological factors extent to understanding physical health problems and is most studied within the field of health psychology.

and what are areas of psychology in public

health?

So, how dose psychology contribute in health

problems?

The various roles of psychology

Psychological theories

Psychological models

Health Belief Model (HBM)

It was developed initially by Rosenstock (1966) and further by Becker and colleagues throughout the 1970s and 1980s (Becker & Rosenstock 1987)

The HBM predicts that behaviour is a result of a set of core beliefs.

Behaviour is predicted by beliefs in: Susceptibility and severity of illness; the costs and benefit involved in carrying out the behaviour; cues to action, which may be internal or external; health motivation, and perceived control

Theory of Planned Behavior (TPB)

The TPB proposes that behavioural intentions (‘plans of action in pursuit of behavioural goals’) are a result of the following beliefs (Ajzen 1988) :

-Attitude towards a behaviour

-subjective norm

-perceived behavioural control

(internal & external)

Self-regulatory model Leventhal and his colleagues (1997) defined

illness cognitions as ‘a patient's own implicit common sense beliefs about their illness’.

five cognitive dimensions of these beliefs: Identity ; perceived cause of illness; time line; consequences ; curability and controllability.

This process occurs via the three stages of interpretation, coping, and appraisal.

Psychological investigations

Obesity and diet researches highlighted the importance of factors such as the food industry, food advertising, food labelling, the availability of energy dense foods.

An environment which has been increasingly designed to encourage a sedentary lifestyle through the use of cars, computers, and television.

Central to this change is a shift in two key behaviours; eating behaviour and physical activity

Health psychology theory provides a framework for:

1-understanding behaviours and beliefs and ;

2-exploring how these factors may relate to illnesses.

These theories have drawn on:

1- social cognition models,

2-implementations intentions and ;

3-the self regulatory model to inform interventions aiming to change behaviours and beliefs.

Developing interventions to change health-related behaviour

So, how do our psychological models work to change behaviors ?

Or

Or

1. Identify target behaviour and target population;

2. identify the most salient beliefs about the target behaviour in the target population using open-ended questions;

3. conduct a study involving closed questions to determine which beliefs are the best predictors of behavioural intention. Target the best belief ;

4. analyse the data to determine the beliefs which best discriminate between intenders and non-intenders;

5. develop an intervention to change these target beliefs

Using social cognition models (SCMs)

Using implementation intentions

SCMs emphasize the relationship between the intention to behave in a certain way and actual behaviour. However, that intentions do not always translate into behaviour.

Some experimental research has shown that encouraging individuals to make implementation intentions can actually increase the correlation between intentions and behaviour

Using the SRM Research indicates that patients' beliefs about their illness may

relate to a range of health outcomes in terms of adherence to medication, attendance at rehabilitation, return to work, and adjustment.

Interventions have therefore been developed to change beliefs and promote more positive outcomes.

Petrie et al. (2002) studied cognition of MI patients .the results showed that patients who had received the intervention reported more positive views about their MI at follow-up in terms of beliefs about consequences, time line, control/cure, and symptom distress, also hey discharged earlier from hospital and returned to work

Now, what is your own concept about sociology and psychology in public health?

Would you incorporate them into your future’s missions? ..if yes, how?

Conclusion Both sociology and psychology are now well established as part of multi-

disciplinary public health and are increasingly forging new partnerships with anthropology, social policy, and geography in studying public health issues.

sociological investigation remains the worldwide concern with socioeconomic and gender inequalities in health, often manifest through inequities of access to healthcare, in particular for ethnic minorities, refugees and older age.

Another increasing policy focus is the importance of health promotion and health education based on behaviour change techniques to achieve risk reduction through life style change and for chronic disease management.

Thank you for listening

"If you don’t know where you’re going, you wind up someplace else." Yogi Berra