1. H571 – Week 1 Introductions Review of syllabus
Name, program, year, prior experiences with HP and interests for this course
Complete sign-in form – indicating your health behaviors of interest and your preferences for week of presentation
Review of syllabus
Expectations, assignments, questions
All communications via
Use only your ONID address!
Activity – Discussion/Brainstorming
Review DSC Chapters 1 & 2 and NCI
Review TTI

2. Activity 1: What Is Your Topic/Area of Interest?
Think about looking upstream from disease to behavior
Understanding the causes and consequences of a particular health-related behavior
Promoting a particular desirable behavior or preventing a particular undesirable behavior
Amenable to individual-, group- and population-level interventions
List your choice of week to present
See next slide

3. H571 syllabus/course outline
PART I: Introduction, Intrapersonal Theories, Interpersonal Theories
Week 1: Introduction to health promotion and health behavior theory
Week 2: Value-Expectancy Theories
Week 3: Perceived Threat and Fear Appeals
Week 4: Stage Models
Week 5: Social Cognitive Theory
PART II: Sociocultural Theories
Week 6: Behavioral Economics
Week 7: Communications theories (HPHB students)
Week 8: Diffusion of Innovations and Community Theories
Week 10: Ecological approaches and integrative theories (HPHB students)

4. Discussion:
Why is understanding the causes (theories about) and consequences of health behavior important for your topic/area of interest/expertise?
Why is understanding how to change health behavior (and theories about behavior change) important for your topic/area of interest/expertise?

5. Brainstorm: What are the causes of peoples’ behavior? OR
Why do people behave the ways the do?

7. DSC Chapter 1
Health Behavior (HB) in the Context of the "New" Public Health (PH)
Three levels of prevention
Definition of health promotion (HP)
Importance of multiple theories for HP
Understand multiple kinds of theories
HBs are influenced by multiple environments (physical, social, economic, legal, political) as well as intrapersonal factors
Thus, need a broad range of theories

8. Introduction What is health? Is this definition comprehensive?
According to the World Health Organization (WHO): “Health is not merely the absence of disease or infirmity; rather, health should encompass a state of complete physical, mental and social well-being
Is this definition comprehensive?
Reconceptualized at 1986 Conference
Should be defined to encompass the: “extent to which an individual or group is able, on the one hand, to realize aspirations and satisfy needs; and, on the other hand, to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the object of the living; it is a positive concept emphasizing social and personal resources as well as physical capacities.”

9. Public Health Issues, 1900 & 1997

10. Introduction
Chronic Diseases: manifest over time, are not always apparent, may be long lasting or recurring
Infectious Diseases: diseases transmitted through a specific form of contact
How might the role of environment and behavior influence the spread of each disease type?

11. Key Concepts
The United States spends more on health care than any other nation in the world (WHO, 2009)
U.S. only ranks 47th in terms of life expectancy
See Figure 1-2 (next slide)

12. Key Concepts

13. Why Emphasize Prevention?
Some estimates suggest that the U.S. government spends $1,390 per person to treat disease, while spending only $1.21 per person on prevention
E.g., Type 2 Diabetes
Obesity a modifiable risk factor (i.e. can be changed)
If obesity and inactivity reduced, should also experience significant decrease in prevalence of Type 2 Diabetes
1 out of every 5 U.S. federal healthcare dollars is spent treating people with diabetes, from a cost-saving perspective should attempt to prevent rather than treat diabetes, unfortunately in 1999, of the total dollars spent on national health care, only 1% went to population-based prevention

14. Health Behavior is Complex
Changing behavior is not as simple as it seems
Behavior is complex and influenced by many factors, therefore changing it requires deep understanding of a range of influences
Before behavior can be changed, one must understand the determinants of behavior
Can include:
biological and personality characteristics;
family, peers, and community;
socio-cultural influences, the built environment, etc. \

15. Health Promotion is Complex
Health promotion involves two aspects: research and practice
Health promotion research works to understand underlying individual and environmental factors that influence health behavior
Health promotion practice is responsible for designing and implementing interventions to modify factors and ultimately change behavior
Both sides (research and practice) must work together and play an integral role in promoting health.

16. Theory is Complex Theory is a tool used in both research and practice
Definition: Theory is a set of testable propositions that is used to explain a group of facts of phenomena
In health promotion, theory is viewed as a tool for enhancing our understanding of complex situations versus something that offers universal explanations or predictions (Green, 2000)

17. However…
Social scientists have used the term “theory” to mean several different things (there is little consensus):
A set of empirical generalizations
A unified, systematic causal explanation for various phenomena
A theoretical orientation (or “school-of-thought”)
A single theory (e.g. Critical Theory)
Hypotheses, models, conceptual frameworks

18. Important to remember Commonsense theories and
Scientific theories have a key element in common:
They represent efforts at making sense of the world in which humans live; it’s a meaning-attribution activity; an attempt to “tell stories about how things work”
HOWEVER, ONE BIG DIFFERENCE:
Scientific theories have been tested and found valid across multiple populations and contexts

19. Definitions from NCI
Concepts are the building blocks—the primary elements—of a theory.
Constructs are concepts developed or adopted for use in a particular theory.
Variables are the operational forms of constructs. They define the way a construct is to be measured in a specific situation. Match variables to constructs when identifying what needs to be assessed during evaluation of a theory-driven program.
Models may draw on a number of theories to help understand a particular problem in a certain setting or context. They are not always as specified as theory.

20. Types of Health Behavior Theories
Explanatory theories
Help understand the causes/determinants of a behavior
Descriptive
Change theories
Guide the development of interventions
Process oriented

21. Theory to Practice
Effective practice depends on using theories and strategies that are appropriate to a situation:
The target condition or behavior
The target population
Units of analysis or change
The type of behavior to be addressed

22. The Public Health Approach
Public health seeks to promote health, prevent early mortality and morbidity, and enhance or ensure quality of life
Prevention is the basic principle underlying the public health approach
Public health focuses on populations (or groups of people); it is not clinical (or focused on individuals)

23. The Public Health Approach
Prevention of disease requires more than just avoiding clinically observable illness
Figure 1-3: The wellness/illness continuum
If work from right to left (medical to prevention) begins with a diagnosis and is reactive, limits public health approach to changing people one at a time, the prevention to medical orientation lends itself to a population level approach because it is not predicated on an individual medical diagnosis

24. Primary Prevention Public health predicated on primary prevention
Primary prevention: efforts are made to intercept the onset or occurrence of disease, injury or behavior.
Ex: vaccination programs, abstinence programs, bicycle helmet laws for children
Involves intervening before disease onset

25. Public Health Approach
Universal approach: When an entire population or subgroups of the population are targeted regardless of whether individuals have specific risk factors
Selective approach: primary prevention efforts targeted at those in the population who are at heightened risk.
Typically targeted based on biological, psychological, social or environmental risk factors
Universal approach: If the preventative effort corresponds to a high rate within the population (i.e. diabetes, obesity, alcohol abuse) then the universal approach is very cost-effective. If the rate is infrequent in the population, this may not hold true
Selective approach: Ex: Obesity is a risk factor for diabetes so if you want to combat Type 2 diabetes, target individuals whose BMI is above 25, who have not yet developed Type 2 diabetes

26. Secondary Prevention
Secondary prevention occurs when a disease process is diagnosed in an early stage of progression, thereby enhancing the odds of treatment success.
Focus is to minimize consequences through early detection and intervention.
E.g., Screening programs for STDs, mammography or smoking cessation programs

27. Tertiary Prevention
Tertiary prevention occurs when a disease state is diagnosed in time to apply treatment that may preserve further organic damage or death
Involves mitigating the consequences of disease or an injury after the fact
Difference between Secondary and Tertiary Prevention can be thought of as the difference between early and late diagnosis

28. Tertiary Prevention
Indicated approach used in tertiary prevention- designed for individuals who have a risk factor that put them at very high risk
E.g., Providing mental health counseling for rape victims, providing patients who have Type 2 diabetes with educational pamphlets to help them better manage their disease
Tertiary prevention in the public health model is similar to treatment in the medical model

29. Three Levels of Prevention

30. Activity
Discussion of the most appropriate level of prevention for your chosen topics

31. Health Behaviors
Behavior- the manner in which something acts, functions, responds, or reacts.
Health behavior- the actions, responses or reactions of an individual, group or system that prevent illness, promote health and maintain quality of life
E.g., individual health behavior: using a condom, getting vaccinated, buckling your seatbelt
E.g., group health behavior: improving public parks, instituting a citywide smoking ban

32. Three Categories of Health Behaviors
Preventive behavior: Health-related behaviors of people who are healthy and try to maintain their health
Illness behavior: behavior undertaken by individuals who perceive themselves to be ill and who seek relief or definition of illness
Sick-role behavior: the treatment plan once an individual is diagnosed with a disease

33. Health Behaviors

34. “New” Public Health
Increased emphasis on the significant role of environmental influences in shaping individual behavior and affective health (i.e. culture, policy, technology, urbanization, built environment)
Health promotion: the art and science of motivating people to enhance their lifestyle to achieve complete health, not just the absence of disease

35. Figure 1-6: Health Promotion Strategies
Each strategy can be applied to a range of settings, risk factors, population groups, diseases or negative health outcomes. Strategies not applied in isolation, overlap and are integral to achieving health promotion objectives

36. Health Promotion What is missing from the last image?
Health promotion researchers, policy makers and practitioners use theory to guide many of their health promotion strategies.
Health promotion is a process; therefore, defines itself in terms of its goals and strategies.
Relies on theoretical contributions from many other disciplines (social psychology, sociology, child development, education, etc.)

37. DSC – Chapter 2 Understand: That health behaviors are diverse
Proximal and distal influences
And ultimate/fundamental causes
How Theory Informs Health Promotion and Public Health Practice
Use of theory in multilevel approaches to prevention/HP

38. Introduction
Theory has become an indispensable tool for the development, implementation and evaluation of public health initiatives
It enables researchers to better understand and change health behavior

39. Role of Theory Theory can be used to:
Define the specific objectives/strategies
Related to a targeted behavior
Meant to alter hypothesized mediators
Or causes of the targeted behavior
To lead to effective behavior change
Note the emphasis on effective – not all HP is effective
For a large number of people
the objective of public health (in contrast to clinical services)

40. Health Behaviors are Diverse
Three dimensions of health behavior
Complexity, frequency, volitionality
Complexity: involving higher levels of knowledge, skill or resources to perform than simple behaviors
E.g., Correct use of the male condom involves at least 10 steps; the more complicated the behavior, the lower the likelihood it will be performed correctly

41. Health Behaviors are Diverse
Complexity not always inherent in the behavior, can be a function of the environment
E.g., Getting a flu vaccine may not be complex for a middle class American with health insurance; however, the same behavior may be high in complexity for a person living in isolated, rural poverty

42. Health Behaviors are Diverse
Frequency: Health behaviors can be frequent and repetitive (diet and exercise), one time only (screening for radon), or periodic (obtaining a mammogram)
Behaviors may be highly complex but only require infrequent repetition (colorectal cancer screening) or complex and require daily repetition (consuming a low-fat diet)

43. Health Behaviors are Diverse
Volitionality: the degree of personal control over the behavior
Highly volitional behavior is one over which the person has complete control; performing the behavior does not require external resources, assistance or support (i.e. flossing)
Behaviors low in volitionality require reliance on external resources (i.e. consuming fresh produce, may not be affordable or available)

44. Theory at Multiple Levels
Much like health behaviors, theories are also diverse
Theories can be applied at several “levels” within the environment
See Figure 2-2 (next slide)

45. Figure 2-2: Socioecological Model

46. Ecological Framework
Outer levels influence inner levels all the way down to the individual (“I” in the inner-most circle)
The individual is often the “target” of the intervention; however, making changes at any of the levels can influence individual health behavior
Ecological approaches are now widely believed to be more effective than single-level approaches
Example: When assessing whether older adults in Denmark received an influenza vaccine, individual factors such as barriers/benefits to vaccination where cited, however, factors such as type of housing and living arrangements were also found to be associated with vaccination rates

47. Proximal vs. Distal Influences
Proximal Influences: inner-level factors that are close in proximity to the individual (“I”)
Distal Influences: factors located in the outer levels, that do not always directly or immediately affect the individual due to their location in the model
See Box 2-1 (next slide)
Ex: Taxes on cigarettes and tobacco smoking regulations, distal influences on tobacco use. May have broad impact and eventually influence individual-level behavior

48. Box 2-1: Proximal vs. Distal Influences
Ex: Taxes on cigarettes and tobacco smoking regulations, distal influences on tobacco use. May have broad impact and eventually influence individual-level behavior

49. However …..
We see a slightly different formulation in the TTI (and in Week 10)

50. Role of Theory
Theory helps us to develop an organized, systematic and efficient approach to investigating health behaviors (so we are not just guessing at distal and proximal influences!)

51. Informal Steps to the Inductive Approach
Your own hunch about the nature of the health behavior and underlying causes
Think about the health behavior from a theoretical perspective
Conduct an empirical evaluation (relying on published literature) that suggests underlying causes of risk and protective behaviors

52. Inductive Approach
These steps serve to identify the determinants of a specific health behavior
Determinants: factors that influence the health behavior (levels of influence in the Ecological and TTI Models)
Determinants may range from individual characteristics such as knowledge, attitudes and beliefs, to social factors such as family, friends and community, to environmental (or sociocultural) factors such as laws, economics, politics, religion, culture

53. Inductive Approach
It is determinants/mediators that we target to affect behavior change
By changing multiple determinants, we may be able to induce lasting behavioral change
Theory helps researchers and practitioners highlight determinants/mediators more quickly and effectively

54. Program Planning

55. Multi-level Intervention
The ecological approach uses theory to create intervention points across several levels
Multi-level: implies at least two of the following ecological levels have been examined: individual, familial, relational, peer, community, societal or policy/legal
When interactions between levels are examined, we gain a greater understanding of health behaviors

56. Hypothesized Mediators
Mediator: represents the determinant targeted by the intervention and its association with the health behavior
When the determinant is theory-derived, referred to as a hypothesized mediator
Hypothesized mediator “comes between” intervention and behavioral outcome
Ex: Identify cost as a barrier to vaccination, eliminate the hypothesized mediator (offer vaccines for free), expect an increase in vaccination uptake

57. Objectives
An objective is a quantifiable action that (when achieved) will contribute to achieving behavior change
E.g., Breastfeeding. Suppose social support is a hypothesized mediator of breastfeeding among first time mothers. If the goal of the intervention is to increase breastfeeding, the objective to enhance social support networks has a chance of being effective.

58. Objectives
Theory guides the identification of objectives that (if achieved) will lead to changes in the behavior
Figure 2-4:

59. Ecological Approach
May be most appropriate to health behaviors that are complex, require frequent repetition and require external resources (i.e. changing lifestyle behaviors that lead to obesity and diabetes)
Some of the most powerful approaches may be too expensive for use by local public health professionals – require access to changing policies/regulations/laws (or poverty!)

60. Conclusion
Theory is a vital tool in health promotion practice and research
Theory selection and use is one essential part of program planning that guides intervention development
One theory does not fit all needs, program objectives are diverse and, thus, integrated theories or a selection of theories may be useful

61. The Theory of Triadic Influence
Snyder & Flay, 2012: Brief introduction to the Theory of Triadic Influence (TTI)

62. Proximal Correlates of Behavior
Social skills Self management Self-efficacy
Social Norms theories
Conformity theories
Expectancy theories
Attitude theories
BEHAVIOR
Intentions/Decision
Attitudes Toward
Behavior
Social Normative
Beliefs
Self-Efficacy
Theory of Planned Behavior
Theory of Reasoned Action

63. Distal Causes of Behavior Person-Situation-Environment (Lewin, 1951)
Biological theories
Psychoanalytic theories
Resilience (Garmazey)
Personality theories
Self-Control
(Gottfredson & Hirschi)
Social Control (Elliott)
Family Systems (Brooks)
Peer Clustering (Oetting)
Class Conflict
Low SES, Anomie
Social Disorganization
Strain Theory (Merton)
Radical Theories
GENETICS
ENVIRONMENT
BEHAVIOR
Intentions/Decision
IntraPersonal
Environment
Social Situation

64. THE THEORY OF TRIADIC INFLUENCE
GENETICS
ENVIRONMENT
IntraPersonal
Environment
Social Situation
Attitudes Toward
Behavior
Self-Efficacy
Social Normative
Beliefs
Intentions/Decision
BEHAVIOR 64

65. THE THEORY OF TRIADIC INFLUENCE
Distal
Influences
Proximal
Predictors
Levels of
Causation
Ultimate
Causes
Social/
Personal
Nexus
Expectancies
& Evaluations
Affect and
Cognitions
Decisions
Experiences
Intrapersonal Stream
Social/Normative Stream
Cultural/Attitudinal Stream
Biological/Nature
Nurture/Cultural
BIOLOGY/
PERSONALITY
SOCIAL
SITUATION
CULTURAL
ENVIRONMENT 1 2 3 4 5 6
Sense of
Social
Interpersonal
Others’
Interactions w/
Social Instit’s
Information/
Self/Control
Competence
Bonding
Beh & Atts
Opportunities 7 8 9 10 11 12
Self
Skills:
Motivation
Perceived
Values/
Knowledge/
Determination
Social+General
to Comply
Norms
Evaluations
Expectancies 13 14 15 16 17 18
SELF-EFFICACY
BEHAVIORAL
CONTROL
SOCIAL
NORMATIVE
BELIEFS
ATTITUDES
TOWARD THE
BEHAVIOR 19 20 21 22 23
DECISIONS/INTENTIONS
Trial Behavior
EXPERIENCES: Expectancies -- Social Reinforcements -- Psychological/Physiological

66. THE THEORY OF TRIADIC INFLUENCE Reciprocal Feedback:
Once a behavior occurs, the resulting reactions and/or experiences (thoughts and feelings) feed back to change the original causes
Reciprocal feedback occurs through all streams and levels
Engaging in a behavior changes one’s attitudes, normative beliefs and self efficacy
It also changes one’s knowledge, relationships with parents and peers, and sense of self

67. THE THEORY OF TRIADIC INFLUENCE
Distal
Influences
Proximal
Predictors
Levels of
Causation
Ultimate
Causes
Social/
Personal
Nexus
Expectancies
& Evaluations
Affect and
Cognitions
Decisions
Experiences
Intrapersonal Stream
Social/Normative Stream
Cultural/Attitudinal Stream
Biological/Nature
Nurture/Cultural
BIOLOGY/
PERSONALITY
SOCIAL
SITUATION
CULTURAL
ENVIRONMENT
Values/
Evaluations
Knowledge/
Expectancies
Perceived
Norms
Information/
Opportunities
Interpersonal
Bonding
Social
Competence
Interactions w/
Social Instit’s
Others’
Beh & Atts
Motivation
to Comply
Skills:
Social+General
Sense of
Self/Control
Will: Self-
Determination 1 2 3 7 8 9 10 11 12 13 14 15 16 17 18 l 4 5 6 a b c d e f C F I B E H A D G g h i j k m n o p q r s t u v w x
SELF-EFFICACY
BEHAVIORAL
CONTROL
SOCIAL
NORMATIVE
BELIEFS
ATTITUDES
TOWARD THE
BEHAVIOR 19 20 21 22 23
DECISIONS/INTENTIONS
Trial Behavior
EXPERIENCES: Expectancies -- Social Reinforcements -- Psychological/Physiological
Related Behaviors J K 67

68. THE THEORY OF TRIADIC INFLUENCE Continuous Cycle of Causation:
Feedback changes the likelihood of engaging in the same or a similar behavior in the future
Thus, causes and effects are in a continuous cycle:
With each behavior changing the causes, and
The changed causes leading to the same or similar behavior over time
Mutually influential individual  contextual relations
Developmental regulation

69. Feedback Also Shown This Way
Att
SNB P SE S B I E
Att
SNB P SE S B I E
Att
SNB P SE S
DEVELOPMENT & TIME

70. THE THEORY OF TRIADIC INFLUENCE Role of Related Behavior:
The reactions to certain behaviors feed back to influence the causes of RELATED BEHAVIORS
e.g., smoking and other drug use
- Related behaviors have similar causes, with the more distal causes being the most similar
- Less related behaviors (e.g., smoking and skiing) have fewer causes in common
- Even related behaviors have some differences in proximal causes

71. Closely and less related behaviors:
Ultimate causes may be the same, distal predictors less so. E S P E S P E S P E S P E S P E S P E S P A
single
behavior
Eg,
smoking
Two
closely
related
behaviors.
Eg, smoking
and drinking
Less and
less related
behaviors.
Eg, smoking,
drug abuse,
sex, exercise.

72. The TTI Developmental-Ecological System
Levels of
P P S E P
Eval
Behavior
SNB
Self
Efficacy
Att
Intentions
Will + Skill
Exp Mc NB
Know
Value
Social
Bonds
Role
Models
Self-
Control
Com-
petence
Values
Environment
Knowledge
ENVIRONMENT
Situation
Person
Affective/Control Substreams
Cognitive/Competence Substreams
Causation
Ultimate
Underlying
Causes
Distal
Predisposing
Influences
Proximal
Immediate
Predictors
DEVELOPMENT & TIME 72

73. Supplementary Slides Reasons for thinking theoretically:
Material from Goodson, Patricia (2010). Theory in Health Promotion Research and Practice: Thinking Outside the Box. Boston: Jones and Bartlett Publishers.

74. Reasons for Thinking Theoretically about Health Promotion
# 1 - Infuses Ethics and Social Justice into Public Health Practice
# 2 - Represents A Moral Duty and A Professional Responsibility
# 3 - Guides the Profession
# 4 - Prevents Ideological Take-Over, or Hegemony
# 5 - Guides and Perfects Practice
# 6 - Builds Scientific Knowledge
# 7 - Provides Roadmaps for Research

75. Reason # 1: Ethics and social justice
The Tuskegee Study
Breech of ethical principles in conducting research.
One of the reasons for ethical mis-conduct:
According to James Jones (author of the book Bad Blood) – medicine, at the time, was a profession “almost wholly composed of people uninterested in theorizing” (Jones, 1993, p. 96).

76. Reason # 1 Tuskegee happened because…
The medical (and public health) profession trained physicians to become
Healing technicians
Health methodologists
Health strategists
Not trained to
Reflect
Inquire
Question the status quo
OR: not trained to think theoretically

77. Reason # 2:Moral duty and Professional responsibility
Professions have defined tasks and values.
Professional tasks and values = professional responsibilities
Most professions  CODE OF ETHICS and PROFESSIONAL COMPETENCIES

78. Reason # 2 Our professional responsibilities include:
Develop our professional tools
Become more effective and efficient
Reflect continually on our practice
Question our methods
Reform our views, when needed
Build narratives that provide meaning for people’s health promotion efforts
Witness / Listen to our clients’ narratives

79. Reason # 2
Theorizing: responsibility embedded in 6 of the 7 areas of professional responsibility for health educators, defined by NCHEC (National Commission for Health Education Credentialing).
Examples:
“Identify factors that influence health behaviors” (Area I – sub-competency C)
“Identify factors that foster or hinder the process of health education” (Area I – sub-competency E)

80. Reason # 3: Guides the Profession
Few scholars are thinking theoretically about the direction health promotion/public health is taking.
Those who have thought theoretically, have contributed:
New theories
New models and perspectives
New approaches
Helpful critiques

81. Reason # 3
Few scholars engage in theoretical thinking about public health because:
It is disquieting
Can be disturbing
Can “rattle the status quo cage”
Yet: THIS is what theory does…

82. Reason # 4: Prevent ideological take-over, or hegemony
Ideology = the integrated assertions, theories and aims that form the collection of plans societies have for governing themselves.
Hegemony = happens when one social group’s ideology dominates another group and becomes the predominant influence over this group (OR: an ideology take-over).

83. Reason # 4
If public health professionals do not build and shape public health’s ideology, professionals outside public health will.
Consider the influence of other fields of knowledge on public health, historically.
Public health cannot exist without an ideology (or set of theories).
Someone has to build these theories and assertions.
If not public health professionals, who?

84. Reason # 5: Guides and perfects practice
Practice = set of activities used to promote health and prevent illness.
“Practice makes perfect”  “Theory makes perfect” (Willinsky, 1998, p.245).
Prevention interventions: more effective when based on theory
Many theories suggest strategies for changing specific factors/variables/elements.
Practitioners may not have to re-invent the wheel, when using these theories.

85. Reason # 6: Builds scientific knowledge
The body of knowledge in a given field needs two types of research:
Descriptive
Analytical
Public Health: too much descriptive research? Not enough analytical?
“Chaos in the Brickyard” letter by Bernard K. Forscher (Science, 1963)
Too many scattered bricks (data)
No buildings (bricks connected in a planned manner)

86. Reason # 7: Provide roadmaps for research
Most fields: asking for more theory-based research
Provides data that can be generalized more broadly (applied to a larger number of contexts/contingencies).
Facilitates conducting and implementing research projects.
Provides blueprint for selecting which variables to measure.
Provides parameters for analyzing (and interpreting) what was measured.
Avoids: Re-inventing the wheel, going around in circles