Social Influences In Health Decision Making

1295 words - 5 pages

Health behaviour theorists have long attested to the importance of social influences in health decision making. For example, the prominent Social Cognitive Theory builds in a construct of outcome expectancies, of which social outcome expectancies, or the value of the anticipated reaction of those in one’s environment, play a role. In essence, an individual is going to consider anticipated approving or disapproving responses, by his/her peers, to a particular health decision, and the perceived reaction will affect the decision that is made (Lusczynska and Schwarzer, 2007). The Theory of Planned Behaviour describes the social influence as subjective norms, which are individual’s beliefs that significant others think that they should engage in a behaviour (Conner and Sparks, 2007). For example, an adolescent may decide to begin smoking if he thinks that his friends have favourable attitudes towards smoking behaviour. Other models have focused on more of a learning and observing approach, such as the Theory of Interpersonal Behaviour, which speaks more specifically about social group subcultures and norms and their facilitating effect on health behaviour decisions (Norman and Conner, 2007). Though these theories describe the effects of the social environment on an individual, at the very base level the individual is consciously making the decision of which health behaviour to engage in. Social Network Analysis (SNA) is a technique that can be used to develop a richer description of the social environment. In addition to identifying peer groups, SNA creates a structural map of the relationships in a given community, and these can be examined on several different levels, including the individual or sub-group level.
In adolescence, the peer group is an important context when attempting to understand and influence health behaviours. Peer influence can occur in several different ways, including modelling (Hundelby and Mercier, 1987) and direct peer persuasion (Graham, Marks, & Hansen, 1991). However, more recent research has acknowledged that simply studying peer influence may ignore other group-level aspects, leading to a greater number of studies which implement the use of SNA to determine network-level measures that enhance the conceptualization of peer influence. Research has focused on many types of troublesome adolescent behaviour, including alcohol consumption (Bot et al, 2005), smoking (Wiist and Snider, 1991; Abel, Plumridge and Graham, 2002; Ennett et al, 2008; Valente, Unger, and Johnson, 2005), substance abuse (Ennett et al, 2006), eating disorders (Hutchinson & Rapee, 2006), and risky sexual behaviour (Okonkwo, Fatusi, and Ilika, 2005). The mechanisms of peer influence in these studies are different but related, and are modified by friendship and group characteristics. For example, in their study about drinking behaviour, Bot et al (2005) found that the friendship dimensions that most affected the tendency to drink alcohol...

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