Division of Health Promotion, Graduate School of Public Health
College of Health and Human Services, San Diego State University
PH 862 Advanced Theoretical Foundations of Health Promotion & Behavioral Science
Fall 2011
Class Schedule:
Location:
Office hours:
Tuesdays, 1:00-3:40pm
Sky Park
By appointment
Instructor:
Elva M. Arredondo, Ph.D.
Associate Professor, Division of Health Promotion
San Diego State University, Graduate School of Public Health
Primary telephone at BACH (Sky Park): 619-594-3481
Fax number: 619-594-2998
Course Description & Goals
This course will cover the theoretical underpinnings of health promotion and behavioral science. We will review
theories that guide the initiation, maintenance, and change of health behaviors. The course is structured around
the Socio-Ecological Framework to examine theories consistent with known determinants at each level of SEF.
Course Objectives & Teaching Methods
The course is designed around three objectives and corresponding teaching and evaluation methods.
Objectives
Name and describe a selected set of
behavioral and social science theories used to
understand health behaviors and health
status, as well to develop or improve
programs to reduce or eliminate major public
health problems.
Identify the assumptions underlying these
theories, and have an in-depth understanding
of the types of health problems, settings,
populations, and cultures in which they have
been used.
Use these theories to analyze a public health
problem in terms of known/probable causes
and/or to identify possible intervention
opportunities. Critically analyze major
strengths and limitations in using these
theories for planning/improving health
promotion/disease prevention programs and
their implementation.
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Varied Teaching methods
Interactive lectures
Discussions of readings
Homework activities
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Interactive lectures
Discussions of readings
Homework activities
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Class participation
Discussion lead
Conceptual Model
Development
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Discussions of readings
Homework activities
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Conceptual Model
Development
Discussion lead
Final paper and
presentation
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Evaluation methods
Class participation
Evaluation Methods
Your performance in the course will be evaluated on the following three assignments. It is expected that all
students will participate actively in the discussions.
1. Conceptual Model Development
Based on the course schedule, students will prepare three 3-4 page papers (not including
references) on their examination of their health topic from at least three levels of the
Socio-Ecologic Framework: intrapersonal, interpersonal, organizational, community, and
policy. Each paper is worth 15 points for a total of 45 points.
The following factors are considered when grading your papers: logic of arguments;
innovativeness; clarity of expression; scholarliness of approach, including appropriate use
of references; and, extent to which the paper addresses the topic of the assignment. Proper
grammar is expected. It does NOT matter if the instructor agrees with the arguments in
your paper –only that they are clearly reasoned, cogently presented, and focused on the
assigned topic. Note that although the web is an appropriate source for some types of
information (e.g. about governmental organizations), it is not considered an appropriate
source for all types of information and should not replace the kind of information gleaned
from peer-reviewed papers or books.
45 pts
Due dates:
Sept 27
Oct 18
Nov 15
The papers must be typed, double-spaced, have page numbers, and use one inch margins
and 12 point Times New Roman font. Please include your name in the top right corner. A
cover page is not necessary. Papers that do not meet these guidelines will not be accepted.
Papers are due at the beginning of class and not accepted via email. If a paper is handed
in late, 10% will be deducted for each day the paper is late.
Each paper will be graded as follows:
 Clarity and organization - 3 points
 Representative content - 7 points
 Spelling, grammar, and typographical errors - 3 points
 Correct use of APA or AMA reference style - 2 points
2. Lead group discussion (second half of class time)
On selected weeks, one student will prepare at least two discussion questions based on the
selected reading and lead the discussion. Your fellow students (those not leading the
discussion) will respond to your questions in writing and turn in their hard-copy responses
to you and the instructor at the beginning of class. Please do not email these responses,
but rather bring them with you to class to aid in the discussion. Responses should not be
longer than one page single space.
During your discussion lead, you should consider using the following format: (1) provide
a brief (10-15 minute) summary of the article(s); and (2) lead a 30-40 minute class
discussion focusing on the following areas:
 critically discuss the application of the theory/conceptual model; consider drawing
one if the authors did not provide one
 critically evaluate the measures of the theoretical constructs, research methods, data
analysis, study results
 If not an intervention, discuss how the model would inform the intervention (include
a table of the constructs and corresponding intervention approach)
 discuss how the theory/model/conceptual framework could be further developed,
and/or additional applications made, specific to health behavior research
15 pts
Your discussion lead will be graded based on the following criteria: Thoughtfulness of
comments, demonstrating evidence of careful preparation and understanding of material;
demonstration of ability to understand, appreciate, and critique alternative viewpoints;
demonstration of active listening as well as participation; creative approaches to issues;
asking insightful questions that help draw out others and/or clarify issues; helping to move
the discussion along and keep it on track; and being on time.
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Following the discussion of the article, the student should lead the case study
discussion
3. Participation
Your responsiveness and participation during the group discussion will be considered in
your final grade
10 pts
4. Final paper and presentation
The final paper and presentation will be a review of the theory that you are taking the lead
with a health topic of interest.
30 pts
o Are the investigators applying the theory properly (based on Noar and Zimmerman’s
critique)? Did they apply all of the constructs? Possible reasons?
o Are they testing a theory? If so, are they examining all of the constructs of the theory?
Why or why not?
o If you are reviewing a topic that has limited studies applying the theory, discuss how
you would apply a particular theory.
o If reviewing an intervention, are the authors using the theory to inform the intervention
and applying it? If not, how would you apply the theory to the intervention?
o The first two paragraphs should describe the theory and the rest of the paper should be
a critique.
o No two people should evaluate the same theory and health topic unless approved by the
instructor
o Review only scientific studies (no reviews)
The papers must be typed, double-spaced, have page numbers, and use one inch margins
and 12 point Times New Roman font. Please include your name in the top right corner. A
cover page is not necessary. Papers that do not meet these guidelines will not be accepted.
Papers are due at the beginning of class and not accepted via email. If a paper is handed
in late, 10% will be deducted for each day the paper is late.
The paper will be graded as follows:
 Responsive to previous critiques – 10 points
 Clarity and organization - 5 points
 Content - 5 points
 Spelling, grammar, and typographical errors - 2 points
 Correct use of APA or AMA reference style - 3 points
The presentation will be graded on clarity, organization, and innovativeness – 5 points.
Course grades will be assigned as follows based on total points accumulated for the semester:
A
AB+
B
B-
96-100
90-95
87-89
84-86
80-83
C+
C
CF
77-79
74-76
70-73
<70
Other issues
 Cell phones and beepers should be turned off during class time; there will be no laptop computers open
during lectures; you may use your laptop during group discussions.
The course schedule was created considering the breadth of information available for us to review, the number
of weeks available to cover this content, and other factors competing with our schedules (your other classes;
holidays, etc). Thus, we are likely to modify this a bit as we progress through the semester. Please note that we
will not discuss the book chapters. They are given to you just in case you do not have sufficient background in
this theoretical perspective to help you get up to speed.
Outline of Course
Wk
1
Date
Aug 30
Discussion Topic and Assigned Readings
Conceptual models
Socio-Ecologic Framework
In-Class Application
Developing a conceptual model
2
Sept 6
Individual level:
 Health Belief Model
Review HBM case study homework
3
Sept 13
Individual level
 Theory of Planned Behavior
 Theory of Reasoned Action
Individual level
 Operant Models—Guest lecture by Dr. John
Elder
Individual level
 Transtheoretical Model
Discuss week 1 articles
4
Sept 20
5
Sept 27
6
Oct 4
Review TRA/TPB case study* (instructor needs to
leave early)
Review ABA homework
Student led discussion on the application
Review TTM case study homework
Student led discussion on the application
Individual level
 Precaution Adoption Process Model
7
Oct 11
Interpersonal level
 Social Cognitive Theory
8
Oct 18
9
Oct 25
Interpersonal level
 Social influence, social networks, and social
support
Community level
 Ecologic model
10
Nov 1
Organizational level
 Chronic Care Model—Guest lecture by Dr.
Linda Hill
Community level
 Policy
11
Nov 8
12
Nov 15
Culture and theory
13
Nov 22
Thanksgiving Break
14
15
16
Nov 29
Dec 6
Dec 17
Student presentations
Student presentations
Finals week – no class session
Student led discussion on the application
Review SCT case study homework
Student led discussion on the application
Review social support case study homework
Student led discussion on the application
Student led discussion on the application
Student led discussion on the Chronic Care Model
Review political economy of health case study
Student led discussion on policy influences
Student led discussion on culture and theories
Final paper due
Other resources:
The National Institute has a website that provides definitions of major health behavior constructs used
in research in public health, health communications, nursing and health psychology, common measures
used to assess these constructs; and descriptions of the construct’s theoretical backgrounds
(http://cancercontrol.cancer.gov/brp/constructs/aboutproject.html)
Another resource is printed in the following booklet:
http://www.cancer.gov/PDF/481f5d53-63df-41bc-bfaf-5aa48ee1da4d/TAAG3.pdf
Readings
Week 1--Introduction
 Health Behavior Theory and Intervention research by Jeffrey, 2004
 Misleading tests of health behavior theories by Weinstein, 2007
 Health Behavior Theory and cummulative knowledge by Noar and Zimmerman., 2005
Week 2—HBM
Readings to review as background:
 Health Belief Model: Janz et al.,
 Health Belief Model in Cervical Cancer Screening by Johnson et al., 2008
 HBM on the heart failure readmission rates in persons with heart failure, by Sethares et al.,
2004
Week 3—TRA/TPB
Readings to review as background:
 Theory of Reasoned Action/Theory of Planned Behavior : Montano et al.,
 Communication norms and condom use in bathhouses by Ellwood et al., 2003
 Application of TPB to sorority alcohol consumption by Huchting et al., 2008
 TPB measurement handout
 Application of TPB: Ezendam et al., 2007
Week 4-OM
Readings to review as background:
 Operant Methods : Nemeroff & Karoly, 1991
 Changing Individual Behavior: Elder et al., 1994
Articles to assist with homework:
 This article provides an example of how to set up a contingency management program for
reducing sedentary behavior in children: Epstein et al., 2004
 Positive reinforcement handout
 Applied Behavioral Analysis for Children and Adolescents, Unit 29: A comparative summary
for procedural selection I
Article for student-led discussion :
 Teaching safety skills to children by Himle et al., 2004
Week 5-TTM
Readings to review as background :
 Transtheoretical Model: Prochaska et al.,
 Validating stage of change measures for PA by Robinson et al., 2008
Article for student-led discussion:
 Transtheoretical Model in Substance Use by Migneault et al., 2005
Week 6-PAPM
Readings to review as background:
 Precaution Adoption Process Model : Weinstein & Sandman
 Osteoporosis prevention in premenopausal women by Blalock et al., 1996
Articles for student led discussion
 Experimental evidence for stages of health behavior change by Weinstein, et al.,1998
Week 7-SCT
Readings to review as background :
 Social Cognitive Theory : Baranowski et al.
 Daughters and mothers exercising together by Ransdell et al., 2001
Article for student led-discussion:
 Self efficacy partially mediates school PA by Dishman et al.,
Week 8-SI, SN, SS
Readings to review as background :
 Book chapter by Heaney et al
 Book chapter by Berkman & Glass
 Social support and patient adherence by DiMatteo
 Critique of social relationship and health research by Cohen, 2004
Articles for student-led discussion
 Triple P parenting intervention by Sanders et al., 2002
Week 9-Ecologic models
Readings to review as background:
 Ecological Approaches: Macintyre & Ellaway, 2000
 An Ecosocial Perspective by Krieger, 2001
 The Ecological Approach in Health Promotion Programs by Kok et al., 2008
 Structural Model of Health Behavior Change by Cohen et al.,2000
Articles for student-led discussion
 The Significance of Parks to Physical Activity and Public Health by Bedimo-Rung et al.,2005
Week 10-CCM
Readings to review as background:
 Organizational change: Steckler et al.
 Reduction of waist and waistlines by Lara et al., 2008
 Introduction to the Chronic Care Model : Bodenheimer et al (2 articles)
Articles for student-led discussion
 Application of Chronic Care Model interventions by Wagner
Week 11-Policy
Readings to review as background

Neighborhood environments and physical activity by Sallis et al., 2009

Engaging school governance leaders to influence physical activity by Cox, et al., 2011

Creating an Environmental Justice Framework for Policy Change in Childhood Asthma by
Kreger et al., 2011
Article for student led discussion

From partnership to policy by Dobson, et al., 2009
Week 12-Culture and theory
Readings to review as background

Book chapter by Resnicow et al.,

Evaluating stage models by Arredondo et al., 2008
Article for student led discussion

Exploring the cultural context of tobacco use: A transdisciplinary framework by Unger et al.,
2003
Week 13 – Thanksgiving break
Week 14+15 - Two class session
Week 16 – Finals week, no class, turn in final paper
Discussion Sign-up sheet
On selected weeks, one student will generate at least two discussion questions and lead a discussion of
approximately 30 minutes on an applied reading. Students are welcomed and encouraged to integrate
information from previous weeks into their questions. The discussion questions are due no later than one week
prior to the week of the discussion. The discussion questions can be delivered via email to all students and
instructors or in person during the prior week’s class. The purpose of this assignment is to develop critical
thinking skills, teaching skills, and listening and synthesis skills.
Week
Student Name
1
No lead
2
No lead
3
No lead
4
Student: Kristi
5
Student: Catherine
6
Student: Jenny
7
Student: Julia
8
Student: Alex
9
Student: Gina
10
Student Kyle
11
Student: Jongho
12
Student: Emily
13
Thanksgiving Break
14
No class
15
Two session class but no lead
16
No class – turn in final paper
Developing Group Discussion Questions
Goals of Group Discussion
 Help students learn to think critically about the subject matter by giving an opportunities for practice
 Help students become aware of and formulate problems using information gained from readings
 Give students an opportunity to formulate applications of principles to one of the assigned health topic areas
 Develop motivation for further learning
Types of Discussion Questions
 Factual questions are primarily used to check knowledge of background information, but can also be used to stimulate
problem-solving.
o How does the author define ______________?
 Application and interpretation questions are used to get at relationships, applications, and analyses of facts and
materials.
o How does the idea of ______ presented in _______ apply to the idea of ________ presented in _________?
 Problem questions involve the presentation of a case or hypothetical problem. The problem may or may not have a
solution, but the problem should be meaningful to everyone in the classroom and one where some progress toward a
solution can be made. These types of questions should not be too abstract but rather grounded in an experience or idea.
o What are the short-term and long-term implications of _____________?
o What solutions would you suggest for _________________?
 Connective and causal effect questions involve attempts to link materials or concepts that may otherwise not appear to
be related.
o What factors may account for ________________?
 Comparative questions ask for comparisons of theories or ideas and provide an opportunity to examine the most
important dimensions of comparison.
o What evidence is there for the ideas presented in ______________?
 Evaluative questions, in addition to asking for comparisons, also ask for a judgment about the relative merit of a giving
point of view.
o What inferences are being made from_______ and are these inferences legitimate?
 Critical questions examine the validity of an argument or discussion.
o On what basis is the argument/idea presented in ______________ valid or invalid?
o What criteria would you use to assess the validity of the argument presented in __________?
In general, discussion questions that can lead in multiple directions will elicit more discussion than simple, single answer
questions. Avoid yes/no questions altogether.
Students will acquire skills in leading and participating in group discussions
 Planning and carrying out a group discussion (opening statement of discussion goals, beginning the discussion,
managing discussion within the time frame, summarizing discussion)
 Managing the group (dealing with monopolizers and eliciting comments from shy individuals)
 Formulating questions
 Formulating ideas and presenting these ideas to a group
 Listening and responding to other group members
 Building on each other’s ideas
For more information on developing discussion questions, see:
Brinkley, A. et al. (1999). The Chicago handbook for teachers: A practical guide to the college classroom. Chicago, IL:
Univ of Chicago Press.
McKeachie, W.J. (1994). Teaching tips. Lexington, MA: D.C. Heath and Company.
PH 862 - Student Information Sheet
Name:
Telephone number (include cell and home):______________________________________________
Emergency contact information:
1. List your degrees and where completed
2. List courses taken in theory – health behavior, health promotion, behavioral science
3. What theory books do you currently own?
4. Is there anything you want me to know about you that will help me refine the class to meet your needs?