Model for incorporating social context in health behavior interventions: applications for cancer prevention for working-class, multiethnic populations

This article proposes a conceptual framework for addressing social contextual factors in cancer prevention interventions, and describes work that operationalizes this model in interventions for working class, multiethnic populations. The Harvard Cancer Prevention Program Project includes three studi...

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Bibliographic Details
Published in:Preventive medicine 2003-09, Vol.37 (3), p.188-197
Main Authors: Sorensen, Glorian, Emmons, Karen, Hunt, Mary Kay, Barbeau, Elizabeth, Goldman, Roberta, Peterson, Karen, Kuntz, Karen, Stoddard, Anne, Berkman, Lisa
Format: Article
Language:English
Subjects:
Behavior Therapy
Cancer prevention
Health Behavior - ethnology
Health disparities
Health inequalities
Health promotion
Humans
Models, Theoretical
Neoplasms - ethnology
Neoplasms - prevention & control
Nutrition
Physical activity
Randomized Controlled Trials as Topic
Research Design
Sociology
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Summary:This article proposes a conceptual framework for addressing social contextual factors in cancer prevention interventions, and describes work that operationalizes this model in interventions for working class, multiethnic populations. The Harvard Cancer Prevention Program Project includes three studies: (1) an intervention study in 25 small businesses; (2) an intervention study in 10 health centers; and (3) a computer simulation modeling project that translates risk factor modifications into gains in life expectancy and number of cancers averted. The conceptual framework guiding this work articulates pathways by which social context may influence health behaviors, and is used to frame the interventions and guide evaluation design. Social contextual factors cut across multiple levels of influence, and include individual factors (e.g., material circumstances, psychosocial factors), interpersonal factors (e.g., social ties, roles/responsibilities, social norms), organizational factors (e.g., work organization, access to health care), and neighborhood/community factors (e.g., safety, access to grocery stores). Social context is shaped by sociodemographic characteristics (e.g., social class, race/ethnicity, gender, age, language) that impact day-to-day realities. By illuminating the pathways by which social contextual factors influence health behaviors, it will be possible to enhance the effectiveness of interventions aimed at reducing social inequalities in risk behaviors.
ISSN:0091-7435
1096-0260
DOI:10.1016/S0091-7435(03)00111-7