Assignment 1 - Please submit your replies here.

Part 1

For either of the case studies readings (Foy, Zoellner, or Shafer), please describe the following:

1. How did the authors use theory?  Where would you place it on a continuum of uses of theory we discussed?

For the Shafer et al. article, they used the Health Belief Model to draft and test messages about HPV vaccinations with diverse mothers.   When considering how they incorporated theory on the continuum of uses we discussed last week, it could be said that they “applied theory” to their project – mapping specific messages from their campaign to constructs from the Health Belief Model and then testing those message with their target population.

2. How did it relate to the uses of theory as described by Bartholemew and Mulen?

They are using the Health Belief Model as a means to change behavior.  According to Bartholemew and Mulen, it seems that they are attempting to lay out “a logic model of change.” That is, they are using theory to craft and test different messages to determine which have the most resonance with the target audience, including which are likely to motivate these mothers to vaccinate their daughter or talk with their daughter’s pediatrician about vaccination. 

3. In you view of the work, how much did they explanation of the data ‘fit’ the theoretical components?

In my opinion, they did an excellent job explaining how each of the messages were created based on theory, especially in Figure 3 in which they mapped each message from the flyer to a Health Belief Model construct.  They also clearly explained why they felt the model was relevant for their work in the beginning of the Methods section, as well as how they combined it with elements of Prospect Theory to frame the messages in either a positive or negative way.

Part 2

1. Select a behavior that is relevant to your area of interest. 1a.Which levels (individual, social, institutional, environmental) are most likely to have a significant role? 1b. Who would you engage to develop a formative project to understand more about this behavior?

A major patient-level behavior of interest for my area of research is use of an online patient portal (or personal health record) among diabetes patients at San Francisco General Hospital, which we hypothesize could lead to improved satisfaction with care and potentially improved diabetes control (through increased communication with providers about self-management).

1a. While all of the individual, social, institutional, and environmental levels are likely to influence portal use to some extent, I believe that individual patient-level factors will be most important.  That is, among patients who have the ability to access and use the Internet, it will be their own perceptions of using the portal to manage their health that will be the most influential.  Secondarily, their relationship with their providers is also likely to drive some use at an institutional level, as patients who have providers who recommend and are engaged in communication via portals are most likely to be active users themselves.

1b. I am planning to engage patients in in-depth interviews to understand more about this behavior. I may also conduct a provider focus group on this topic to understand physician and staff engagement.

2. For one of the behaviors relevant to your outcome, complete a table relating variables relevant to your behavior to theories presented in class and in the readings. Can you expand on these individual factors, to include other factors at the social, institutional and environmental levels?

For my project, I am using the theory of planned behavior because it addresses individuals’ attitudes and beliefs, which can be applied to how patients view the use of technology like portals within the context of their everyday lives.  I have attempted to outline how this theory applies to my work as follows: