Social and Behavioral Social and Behavioral Health Sciences ResearchHealth Sciences Research

Julie Baldwin, Ph.D.Julie Baldwin, Ph.D.Professor, Department of Professor, Department of

Community & Family Community & Family HealthHealth

University of South FloridaUniversity of South Florida

The Social and Behavioral The Social and Behavioral Sciences: Core ConceptsSciences: Core Concepts

• AnthropologyAnthropology

• SociologySociology

• DemographyDemography

• PsychologyPsychology

Social & Behavioral Sciences Social & Behavioral Sciences ObjectivesObjectives

• Develop theories, models or conceptual Develop theories, models or conceptual frameworks to explain health behavior frameworks to explain health behavior or health problemsor health problems

• Test hypotheses based on those theoriesTest hypotheses based on those theories• Use results to design effective Use results to design effective

interventionsinterventions– Efficacy trials in controlled settingsEfficacy trials in controlled settings– Effectiveness in natural settingsEffectiveness in natural settings

Social and Behavioral Social and Behavioral Science CharacteristicsScience Characteristics

• Use scientific methodUse scientific method– Organized way of asking questions and Organized way of asking questions and

analyzing dataanalyzing data– Objective, replicable, verifiable & Objective, replicable, verifiable &

preciseprecise

• We are influenced by socio-cultural We are influenced by socio-cultural environmentenvironment– Must be aware of assumptions made as Must be aware of assumptions made as

interpret others behaviorinterpret others behavior

Social Science MethodsSocial Science Methods

• Interviewing - formal interaction Interviewing - formal interaction between researcher and participantbetween researcher and participant

• Observation of phenomena in their Observation of phenomena in their natural environmentnatural environment

• Experimental design - manipulating Experimental design - manipulating situation in order to test behavior situation in order to test behavior patternspatterns

TheoryTheory

• Set of interrelated concepts, Set of interrelated concepts, definitions, & propositions that definitions, & propositions that present systematic view of present systematic view of phenomena by specifying relations phenomena by specifying relations among variables, with the purpose among variables, with the purpose of explaining and predicting of explaining and predicting phenomenonphenomenon– GeneralityGenerality– TestabilityTestability

• Models and conceptual frameworksModels and conceptual frameworks

Emergence of Emergence of Social Ecology Model Social Ecology Model

• After ‘sanitary awakening’, many After ‘sanitary awakening’, many problems remainproblems remain– Unequal distribution in populationUnequal distribution in population

• Replacement of infectious diseases Replacement of infectious diseases with chronic diseases with chronic diseases – Required understanding of health Required understanding of health

behaviorbehavior

Unifying Model: Unifying Model: Social Ecology ModelSocial Ecology Model

• Builds on traditional model (host-Builds on traditional model (host-agent-environment)agent-environment)

• Incorporates social environmental Incorporates social environmental variables into modelvariables into model

• Highlights socio-cultural contextHighlights socio-cultural context• Directs attention to complex, multiple Directs attention to complex, multiple

conditions and processes conditions and processes • Problems viewed within broader Problems viewed within broader

context of social and physical context of social and physical environmentenvironment

SEM Is MultilayeredSEM Is Multilayered

• Human relationship to disease and Human relationship to disease and health ordered into different layers:health ordered into different layers:– IndividualIndividual– SocialSocial

– FamilyFamily– CommunityCommunity

– Living and working conditionsLiving and working conditions– Broad conditionsBroad conditions

– StateState– GlobalGlobal

Social Ecology Model-Social Ecology Model-VisualVisual

Social Ecology Model-Social Ecology Model-VisualVisual

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Broad Conditions and Broad Conditions and PoliciesPolicies

• InstitutionsInstitutions– Church policies and relationsChurch policies and relations– Educational policies Educational policies – Economic conditionsEconomic conditions

• Broad social conditionsBroad social conditions– Income inequalityIncome inequality– UrbanizationUrbanization– RacismRacism

• State level policiesState level policies• Global systemsGlobal systems

– Trade agreementsTrade agreements

Living and Working Living and Working ConditionsConditions

• Employment statusEmployment status• Occupational hazardsOccupational hazards• SESSES• EnvironmentEnvironment

– TransportationTransportation– Water and sanitationWater and sanitation– HousingHousing– Park facilitiesPark facilities

• Public health, health, and social servicesPublic health, health, and social services

Interpersonal or SocialInterpersonal or Social

• Family networks and dynamicsFamily networks and dynamics• Community factorsCommunity factors

– Social cohesionSocial cohesion– Environmental factorsEnvironmental factors– CrimeCrime

• OthersOthers

Individual or Individual or Intrapersonal LevelIntrapersonal Level

• Biological or innate characteristicsBiological or innate characteristics• Social characteristicsSocial characteristics• Individual behaviorIndividual behavior

IOM Report IOM Report RecommendationsRecommendations

• Need to understand the social Need to understand the social ecology model (SME)ecology model (SME)

• Use SME to identify pathways and Use SME to identify pathways and design effective interventionsdesign effective interventions

• Recognize and address interactions Recognize and address interactions between determinantsbetween determinants

• Acknowledge need for multiple Acknowledge need for multiple approachesapproaches

Other SkillsOther Skills

• Community collaborationCommunity collaboration• Ability to work with stakeholdersAbility to work with stakeholders

– BusinessesBusinesses– MediaMedia– AcademiaAcademia

• Interdisciplinary researchInterdisciplinary research• Team workTeam work• Advocacy and policy developmentAdvocacy and policy development

Examples of SBS Examples of SBS Research in HIV/AIDS Research in HIV/AIDS

PreventionPrevention•Preventive InterventionsPreventive Interventions•Measurement/AssessmentsMeasurement/Assessments•Translational researchTranslational research

Preventive interventionsPreventive interventions

•Elucidate factors linked to Elucidate factors linked to HIV/AIDS acquisition and HIV/AIDS acquisition and transmission and develop and transmission and develop and test innovative, multi-level test innovative, multi-level preventive interventions preventive interventions

Preventive Interventions:Preventive Interventions:Study ExamplesStudy Examples

1)1) Exploring the role of stigma as it may Exploring the role of stigma as it may influence risk behaviors associated influence risk behaviors associated with HIV acquisition and transmissionwith HIV acquisition and transmission

2)2) Formative studies on HIV-related Formative studies on HIV-related behaviors in HIV+ adolescentsbehaviors in HIV+ adolescents

3) Developing and testing theoretically-3) Developing and testing theoretically-based and culturally sensitive HIV based and culturally sensitive HIV preventive interventions targeting preventive interventions targeting individual, social, and environmental individual, social, and environmental factors for vulnerable populationsfactors for vulnerable populations

Measurement/Measurement/AssessmentAssessment

• Measurement quality – developing Measurement quality – developing instruments, establishing reliability and instruments, establishing reliability and validity of measures, and ensuring the validity of measures, and ensuring the cultural appropriateness of measurescultural appropriateness of measures

• Administrative methods – testing Administrative methods – testing different methods for collecting datadifferent methods for collecting data

• Research designs – using state-of-the Research designs – using state-of-the art research designs and mixed-art research designs and mixed-methods approaches to evaluate methods approaches to evaluate programsprograms

Measurement/Measurement/Assessment ExamplesAssessment Examples

1)Assessment of measures of behavioral 1)Assessment of measures of behavioral skills required for sexual risk reductionskills required for sexual risk reduction

2)Studies related to measurement of 2)Studies related to measurement of knowledge of risk and acquisition of STIs, knowledge of risk and acquisition of STIs, including HIV and HPVincluding HIV and HPV

3)Measurement of sociocultural and 3)Measurement of sociocultural and structural determinants of HIV disparities structural determinants of HIV disparities in particular populationsin particular populations

4) Evaluation of HIV/AIDS prevention 4) Evaluation of HIV/AIDS prevention programsprograms

Translational Translational Research/Community Research/Community

EngagementEngagement• Foster cross-disciplinary Foster cross-disciplinary

dissemination and implementation dissemination and implementation science with the ultimate goal of science with the ultimate goal of improving public health and clinical improving public health and clinical practice settings through the practice settings through the availability, adoption, adaptation, availability, adoption, adaptation, and sustained maintenance of and sustained maintenance of evidence-based HIV/AIDS preventive evidence-based HIV/AIDS preventive servicesservices

Translational Research Translational Research ExamplesExamples

1)1) Identify culturally appropriate HIV/AIDS Identify culturally appropriate HIV/AIDS research methodologies for engaging and research methodologies for engaging and collaborating with communitiescollaborating with communities

2)2) Characterize the factors necessary for Characterize the factors necessary for increased implementation of recommended increased implementation of recommended HIV prevention services HIV prevention services

3) Translate effective prevention and 3) Translate effective prevention and adherence programs into practice; adherence programs into practice; integrate programs across mental health, integrate programs across mental health, drug abuse treatment and public health drug abuse treatment and public health care systemscare systems