Chapter 6 Social, Cultural, and Environmental Theories (Part II)

Communication...who says what in which channel to whom and with what effect..

COMMUNICATION THEORY  Communication is the production and exchange of information by use of signs and symbols. The processes involved include encoding, transmission, reception (decoding) and synthesis of information and meaning (Gerbner).  Political theorist Harold Laswell argued that key components of communication include: The sender (encodes/transmits) The receiver (decodes the information, acts on it) The channel “Let’s have dinner tonight” The message The effect =

COMMUNICATION THEORY  Other factors affecting the communication process include: Context of the communication (e.g., formal, informal) Relationship between sender and receiver The meaning attached to the channel (e.g., Wall Street Journal vs. gossip) The process of encoding and decoding itself

COMMUNICATION AS A CODE  What do we mean by that? When you as a speaker send a message to another person or a group of people, what do you do? Do you simply utter a string of information? NO…you put the information into a CODE that will make sense to the intended recipient. [Advertisers are experts at encoding information. In a NIKE commercial with Michael Jordan wearing the “Air Jordan” shoes, what message is ENCODED? When the message gets to the recipient, the recipient DECODES it to interpret its meaning(s). Why is important to CODE messages appropriately?

COMMUNICATION THEORY, CONT’D  What is a communication channel? Is the MEDIUM through which you transmit the information: newspapers, TV, video, internet, interpersonal communication, rallies, etc. Channels can also be more specific, like Hispanic newspapers, or college radio, or thru churches, etc.  The use of media and communications in public health aims to provide information, influence behavior change, and impact the AGENDA of what people are concerned about, in order to set the stage for action.

THINGS TO THINK / CRITIQUES  It is sometimes complicated and difficult to assess the impact of a communications effort. Why? Because there are many levels of possible impact: Simple exposure – how many of the intended audience were exposed to the message? How many of those exposed will make the behavior change?

COMMUNITY AND ORGANIZATIONAL CHANGE  In many situations, change in the health behavior of individuals first requires change in the community itself, in norms, laws, physical conditions, systems, or organizations relevant to the situation.  Communities, organizations and systems can either support or inhibit health behavior change. You can not expect people to engage in HIV preventive behavior if the community exerts strong pressures on individuals NOT to discuss or even admit to any risk for the disease.

COMMUNITY MOBILIZATION  Community mobilization efforts involve collective action by groups and community members to increase awareness about the problem, advocate for policy change, and engage in other activities to address the ecology of a health problem.  Empowerment means that the community takes charge of the issue, defines what the goals are, and takes the necessary action.  By doing that, the community gains experience and sense of efficacy about resolving local problems.  KEY issues in mobilizing communities: Defining the community. Assessing and working with the community’s capacity for mobilizing. Understanding the community agenda and selecting the right issue.

ORGANIZATIONAL AND SYSTEMS CHANGE  Organizational development (OD) is both a philosophy and an approach to organizational change that view organizations as systems of human beings.  Organizational change improves the capability of organizations and systems to respond to health issues through a change process that focuses on; Assessing and improving group dynamics within the organization/system (the way people work together). Encouraging shared goals and missions. Identifying organizational impediments to change, and “unfreezing” the organization or system to make changes. Involving the organization or system in identifying and implementing new policies and practices.

POLITICAL ECONOMY AND HEALTH  Think about health problems as products of a larger set of social relationships, particularly relationships of socioeconomic structure, class, ethnicity and gender.  A health problem (and co-occurring health problems) can be seen as part of a trajectory of risk or trajectory of exposure shaped by the larger social relationships in which exists.  Under this approach, solutions must address the social relationships (e.g., economic patterns, relationships of ethnicity, etc) that contribute to the problem.  Example: Why has HIV/AIDS in the U.S. had a such a disproportionate effect on poor, minority urban communities? How does that setting impact the problem?

ANTHROPOLOGY AND CULTURAL THEORY  Biological anthropology focuses on health behavior as a species adaptation to (or interaction with) an environment.  Cultural anthropology understands and explains health behavior as part of a pattern of living that integrates action with meaning, symbols, and values, as these are connected to a larger social structure. In other words, behavior cannot be separated from its larger context.  Example: Use of health care services (a behavior) in an urban immigrant community may be an outcome of integrated factors: language barriers, economic resources (to pay for care), beliefs about the nature, cause and treatment of illness (culture), social hierarchies in the community, etc.