GRADUATE SCHOOL OF PUBLIC HEALTH
College of Health and Human Services
Division of Health Promotion
Spring 2012
Course Syllabus
PH861: Health Behavior Measurement
Day/Time:
Location:
Instructor:
Phone:
Mondays 4-6:40 PM
Sky Park & Site Visits
John Elder
594-2997
Office: 9245 Sky Park Court, Suite 221
Office hrs: by Appt.
Schedule Number: 56582
Prerequisites: Enrollment in PhD program, or permission.
Course Description: PH 861 is designed to equip the advanced public health student in the measurement
of health behavior as well as disease risks, biological correlates, and broader social and environmental
factors that interact with the behavior. The framework for the course is the Socioecological Model, which
addresses these various levels of measurement. Students will develop knowledge and abilities in
biological assessment, questionnaires and their development, behavioral observation, and community and
broader assessment. This course is meant to be an overview rather than a detailed investigation of any one
technique or variable area.
Course Syllabus
Every effort will be made to follow the syllabus content and schedule however if circumstances dictate
there may be modifications necessary during the semester. If such is the case I will make every effort to
notify students in a timely manner.
Course Objectives:
At the end of this course, students will be able to
1) Define key concepts related to the scientific and applied use of health behavior measures Given a
specific research method or health-related category, select an appropriate behavioral measure(s)
2) Define reliability; given a specific variable, select an appropriate reliability coefficient; and
calculate specific reliability coefficients given certain data.
3) Define and describe the application of validity.
4) Describe the purpose and circumstances for testing reliability and validity of measurement
instruments; describe the relationship between reliability and validity. Define and calculate
screening quality coefficients.
5) Describe common measurement errors and how to adjust for these errors.
6) Compare and contrast different methods for survey development.
7) Extend survey methodology to the measurement of social capital, acculturation, racism and
discrimination, quality of life and behavioral economics.
8) Explain and apply methods for item writing, and scaling.
9) Recognize when to conduct reliability assessments and item analysis.
10) Develop, conduct and analyze direct observation of behavior.
11) Apply direct observation methodology to Real Time Data Capture
12) Define basic aspects of biobehavioral assessment.
13) Select a dependent variable of choice, and develop a comprehensive assessment strategy for that
variable spanning the range of socioecological levels.
Core Competencies for the PhD in Health Behavior and PH861
For those of you enrolled in the HB JDP, PH861 will address all of the below core competencies with a
special emphasis on #2 and #3 (below):
COMPETENCY 1. Demonstrate a sound grasp of the major influential theories and models of health
behavior change.
COMPETENCY 2. Demonstrate knowledge of best practices for measuring health behaviors and related
risk factors, and use psychometric principles to develop new reliable and valid measurement instruments.
COMPENTENCY 3. Use qualitative research methods to address health behavior research questions and
to plan interventions.
COMPETENCY 4. Design effective interventions to motivate a change in population health behavior.
COMPETENCY 5. Demonstrate a sound grasp of sophisticated designs that test the effectiveness of
theoretically-based interventions in health behavior.
COMPETENCY 6. Demonstrate a sound grasp of the evidence of the effectiveness of policy
interventions, particularly those focused on environmental incentives, in promoting healthy behavior.
COMPETENCY 7. Demonstrate a basic understanding of the biological basis of health behaviors.
COMPETENCY 8. Demonstrate skills in writing research proposals that would be competitive at the
National Institutes of Health and comparable funding organizations.
Required Text and List of Readings
The Di Iorio text is the only required textbook. The NCI “Health Behavior Contstructs” web page offers
an excellent overview of (primarily) self-report instruments commonly used in health research. Other
articles and chapters will be required to reinforce the content of individual lectures.
Citations:
Measurement in Health Behavior: Methods for Research and Evaluation, Colleen Konicki Di Iorio,
Jossey-Bass, 2005 (abbreviated below as ‘CDI’).
National Cancer Institute/Cancer Control and Population Sciences: Health Behavior Contstructs: Theory,
Measurement and Research. http://dccps.cancer.gov/brp/constructs/
Lecture Schedule:
August 27, 2013:
Elva Arredondo and Kyle Gutzmer: Cognitive Interviewing and Qualitative
Assessment
September 3, 2013
John Elder: Introduction to the Course
September 10, 2013
John Elder: Socioecological Model and levels of measurement.
September 17, 2013
John Elder: Behavioral Observation I
Joe Smyser: Assessment of Social Media
September 24, 2013
John Elder: Behavioral Observation II (130 PM on Campus)
Homework: Design and test your own observation instrument
October 1, 2013
Suchi Ayala: Observations of Grocery Stores
Homework: First half of BEAT Institute should be finished
October 8, 2013
Ruth Patterson: Nutritional Assessment
Homework: 2nd half of BEAT Institute should be finished
October 15, 2013
Simon Marshall: Accelerometry
October 22, 2013
Greg Talavera and HCHS/SOL Staff: Field measures (note: this class
will be held at the Center of Excellence in Chula Vista)
October 29, 2013
Hala Madanat: Intuitive Eating
Heather Corliss:
November 5, 2013
Thom McKenzie: Direct Observation of Physical Education and
Physical Activity
November 12, 2013
Philip Elder: Practical Use of GIS
November 19, 2013
Ming Tsou: GIS technology
November 26, 2013
John Elder: Behavioral Economics and QOL
December 3, 2013
John Elder: Bringing it all together, and future directions
December 10, 2013
Student Presentations
December 17, 2013:
Final Exam
Homework assignment: design and test your own instrument
Homework: BEAT Institute
Ecological Models, Society and Health (January 28)
1. Robert Wood Johnson Foundation (2008). Where we live matters for our health: neighborhoods
and health.
2. Thacker, S. et al. (2006): Measuring the public’s health. Public Health Reports: January/February,
pp 14-22.
3. Fanathum et al. (2007). Women’s involvement in household decision-making and strengthening
social capital—crucial factors for child survival in Ethiopia. Acta Pediatrica.
4. Elder JP, Lytle L, Sallis J, Young D, Steckler A, Simons-Morton D, Stone E, Jobe J, Stevens J,
Lohman T, Webber L, Pate R, Saksvig B, Ribisl K. A description of the social-ecological
framework used in the Trial of Activity for Adolescent Girls (TAAG). Health Education Research
2007; 22:155-165.
Validity, Reliability and Instrument Design (February 4)
CDI 1, 2, 3, 4, 6, 7, 13
Self-Report Instruments (February 11)
Read all categories on the NCI website EXCEPT “Environment”:
http://dccps.cancer.gov/brp/constructs/index.html
Smyth, J et al. Self-report of Cancer-Related Behaviors. http://dccps.cancer.gov/brp/constructs/
Nutrition (February 25)
1. Cadmus-Bertram L & Patterson RE. Overview of nutritional epidemiology.
2. Subar A. et al (2003). Using intake biormarkers to evaluate the extent of dietary
misreporting in a sample of adults: the OPEN study. American Journal of Epidemiology,
158, 1, 1-13.
Qualitative Research and Ethnography (March 4)
1. Chenail, R (2011). How to conduct clinical qualitative research based on the patient’s experience.
The Qualitative Report, 16, 4, 1173-90.
2. Jarrett R et al. (2011). ‘Holler, run, be loud’: strategies for promoting physical activity in a low
income African American neighborhood. Journal of Family Psychology, 25, 825-36.
3. Morse J (2011). Introducing the First Global Congress on Qualitative Health Research: what are
we? What will we do-and why? Qualitative Health Research, 22, 137-56.
4. Sinding C (2010). Using institutional ethnography to understand the production of health care
disparities. Qualitative Health Research, 20, 1656-63.
5. Swift JA & Tischler V (2010). Qualitative research in nutrition and dietetics: getting started.
Journal of Human Nutrition and Dietetics, 559-66.
Cognitive Interviewing (March 4)
1. Warnecke et al. Improving question wording in surveys of culturally diverse populations.
2. Carlson, E. A case study in translation methodology using the Lifestyle Profile II.
3. Collins. Pretesting survey instruments: an overview of cognitive methods.
4. Pasick et al. Quality of data in multiethnic health surveys.
5. CDI 3, 5
Behavioral Economics and Social Capital (March 11)
1. G. Loewenstein and P. Ubel: “Economics Behaving Badly” July 14, 2010
NY Times
URL: http://www.nytimes.com/2010/07/15/opinion/15loewenstein.html
2. Wong YN, Hamilton O, Egleston B, Salador K, Murphy C, Meropol NJ. (2010) Understanding
how out-of-pocket expenses, treatment value, and patient characteristics influence treatment
choices. Oncologist. 15(6):566-76.
3. Rickard BJ, Okrent AM, Alston JM. (2012) How have agricultural policies influenced caloric
consumption in the United States? Health Econ. 2012 Feb 13. doi: 10.1002/hec.2799. [Epub
ahead of print]
6.
Volpp KG, Asch DA, Galvin R, Loewenstein G. (2011) Redesigning employee health
incentives--lessons from behavioral economics. N Engl J Med. 4;365(5):388-90.
7.
CDI 9, 10, 11
Direct Observation (March 18 and 25)
1. McKenzie, T.L. (2010). 2009 C.H. McCloy lecture seeing is believing: observing physical activity
and its contexts. Research Quarterly for Exercise and Sport, 81 (2),113.
2. McKenzie,T. L., Catellier, D., Conway, T., Webber, L., Lytle, L., Elder, J., Pratt, C., & Greiser, M.
(2006). Girls’ physical activity levels and lesson context during middle school physical education:
TAAG Baseline. Medicine and Science in Sport and Exercise, 38(7), 1229-1235.
3. McKenzie, T. L., Marshall, S. J., Sallis, J. F., & Conway, T. L. (2000). Leisure-time physical
activity in school environments: An observational study using SOPLAY. Preventive Medicine, 30,
70-77.
4. McKenzie, T. L., Cohen, D. A., Sehgal, A., Williamson, S., & Golinelli, D. (2006). System for
Observing Play and Leisure Activity in Communities (SOPARC): Reliability and feasibility
measures. Journal of Physical Activity and Health, 1, S203-217.
5. McKenzie, T. L., Baquero, B., Crespo, N., Arredondo, E., Campbell, N. & Elder, J. P. (2008).
Environmental correlates of physical activity in Mexican-American children at home. Journal of
Physical Activity and Health, 5, 579-591.
6.
Flocke & Stange (2004). Direct observation and patient recall of health behavior advice.
Preventive Medicine 38 (2004) 343–349
Measurement of Environments (April 15)
1. Committee on Environmental Health. The Built Environment: Designing Communities
to Promote Physical Activity in Children. Pediatrics 2009;123;1591-1598.
http://www.pediatrics.org/cgi/content/full/123/6/1591
2. K. Glanz and M. Kegler. Environments: Theory, Research and Measures of the Built
Environment. http://dccps.cancer.gov/brp/constructs/environment/environment.pdf
Ecological Momentary Assessment and Accelerometry (April 22)
Shiffman S, Stone AA, Hufford MR. Ecological momentary assessment. Ann Rev Clin Psychol.
2008;4:1-32.
Stone AA, Shiffman S. Capturing momentary self-report data: A proposal for reporting
guidelines. Annals of Behavioral Medicine. 2002;24(3):236-43.
Gorely T, Marshall SJ, Biddle SJ, Cameron N. Patterns of sedentary behaviour and physical
activity among adolescents in the United Kingdom: Project STIL. J Behav Med. 2007
Dec;30(6):521-31..
Dunton GF, Whalen CK, Jamner LD, Henker B, Floro JN. Using ecologic momentary assessment
to measure physical activity during adolescence. Am J Prev Med. 2005 Nov;29(4):281-7.
Matthews CE et al (2012). Best practices for using physical activity moniotrs in population based
research. MSSE, S68-76.
Evaluation and Grading: Grading for the course will be based upon performance of the following
assignments:
1. Classroom attendance & participation, including homework exercises------15%
2. Completion of reading assignments---------------------10%
3. Examination --------------------------------------------------30%
4. Critiques of Classmates Papers-------------------10%
5. Term Paper---------------------------------------------------35%
Readings
Students will write 5 fill-in-the-blank, multiple choice or short answer test questions covering the
weekly readings. These are due prior to that week’s class.
Examination
The final exam will be based on these questions and the lectures. The exam will probe for
knowledge of basic definitions and concepts presented in course material.
Critiques
Each student will prepare a 1 page (max), double-spaced critique of each presentation.
Term Paper
The semester paper is design to explore the ability to adapt and apply course concept to your
own research. It will be written in the format of a grant application methods section. You will
select a health behavior, or risk, syndrome, disease or other category and propose a specific
measurement strategy for their target. Measures must reflect the multiple levels of the
socioecological model, either through the selection of measures and instruments Students must
propose developing at least two new measures, one a self report scale or survey instrument, and
the other using direct observation, either through self-monitoring (EMA/RTDC) or third party
observation (of individuals or environments).
The paper will capture the primary themes of the course, including:
Operationalization
Sampling
Reliability
Validity
Integrated socioecological levels
Pilot testing
Data analysis
Students are encouraged to select topics that they may eventually pursue for dissertation or other
research, OR other topics involving a range of issues that they simply find interesting (e.g. global
warming, emerging infectious diseases, gun control). Nutrition, physical activity, obesity and
tobacco control are not permitted as topics given their coverage in the class lectures.
Topics must be approved by me by March 19 and presented to the class during the last
two class sessions. They are due in full on the last day of the semester.
Course Calendar
January 28
Socioecological Framework for Measurement (Dr. Jim Sallis)
February 4
Background and Fundamentals (JPE)
February 11
Reliability, Validity and Test Characteristics; Knowledge, Attitudes, Practices,
Consequences and Emotions (JPE)
February 18
Major Concepts of Measurement, Types of Measures (Self Report, Observations,
Bio-behavioral, Electronic). Measurement error. Survey Development
Item Writing and Scaling; Item Response Theory. Screening characteristics.
(JPE).
February 25
Nutritional Assessment (Dr. Ruth Patterson)
March 4
Qualitative Assessment (Kyle Gutzmer) and Cognitive Interviewing (Dr. Elva
Arredondo)
March 11
Behavioral Economics and Social Capital (JPE)
March 18
Behavioral Observation I (JPE)
March 25
Behavioral Observation II (JPE)
April 1
(Spring Break)
April 8
Measurement of Environments (JPE); recreation and grocery store Audit (TBA)
April 15
Field Trips: Hispanic Community Health Study (TBA)
April 22
Accelerometry (Dr. Simon Marshall)
April 29
Student Paper Presentations I
May 6
Paper Presentations II
May 13
Final
The University Policy File includes the following statement on absence for Religious Observances: By
the end of the second week of classes, students should notify the instructors of affected courses of planned
absences for religious observances.
Course policies:
Missing class. If you miss a class, it is your responsibility to contact the instructor to discuss
alternatives to any exercise you miss, and to obtain lecture notes, handouts, other materials or instructions
from the course Blackboard site or a classmate.
Testing. Once a test begins, students are not to leave the classroom until all students have
completed the test. Needs should be attended to prior to the test.
Extenuating circumstances. If severe difficulties (e.g., illness, injury, death of a family member)
prevent you from completing an assignment on time, please contact the instructor to discuss alternative
arrangements.
Disability. If you have a disability and anticipate needing any type of accommodation in order to
participate in this class, please contact the instructor and make appropriate arrangements with Disability
Services.
Cheating and Plagiarism. All individual written assignments/presentations must be the student’s
original work.
Disruptive Classroom Behavior. Academic misconduct by a student shall include, but not be
limited to: disrupting classes; giving or receiving unauthorized aid on examinations, reports or other
assignments; knowingly misrepresenting the source of any academic work; falsifying research results;
plagiarizing another’s work; violating regulations or ethical codes for the treatment of human subjects; or
otherwise acting dishonestly. If an instance of academic misconduct is suspected, the student will be
informed of the infraction and the penalty to be imposed. If appropriate, the matter will be referred to the
Department Chair and Dean of the College for mediation. Potential sanctions include a warning, an
admonition, censure, reduction of grade (including a grade of F for the course), disciplinary probation,
suspension, or expulsion.
Safety. This is an evening course. Students are encouraged to park near the Sky Park entrance and
under lights in the parking lot. Students should leave the building in groups.