PH: SABS

Organizational change

The process through which organizations innovate new goals, programs, technologies, and ideas" in order to improve organizational efficiency and effectiveness. The Stage Theory of blank is one theory that explains this process. The seven stages of the stage theory of blank are: 1) Sensing unsatisfied demands on the system; 2) search for possible responses; 3) evaluation of alternatives; 4) decision to adopt a course of action; 5) initiation of action within the system; 6) implementation of the change; and 7) institutionalization of the change.

Determinants of health

The range of personal, social, economic and environmental factors which determine the health status of individuals or populations.

Focus group

A carefully planned series of discussions designed to obtain perceptions on a defined area of interest in a permissive, nonthreatening environment.

Community based participatory research

A collaborative process that equitably involves all partners in the research process and recognizes the unique strengths that each brings. Begins with a research topic of importance to the community with the aim of combining knowledge and action for social change to improve community health and eliminate health disparities.

Diffusion of Innovations

A community-level theory that attempts to describe the rate and process of the adoption of new ideas and behaviors in a specific population or between populations. An innovation is defined as "an idea, practice or object that is perceived as new by an individual or other unit of adoption," while diffusion is defined as "the process by which an innovation is communicated through certain channels over time among the members of a social system." The process of diffusion occurs over the course of five stages: innovation development, dissemination, adoption, implementation, and maintenance. The adoption stage requires that an individual: 1) has knowledge of the innovation (has an awareness that the innovation exists, knowledge of how to use the innovation and how it works); 2) goes through a process of persuasion or attitude development, in which the individual discusses the innovation with others and forms a favorable or negative attitude toward it; 3) decides to adopt the innovation; 4) implements, or begins to use the innovation; and 5) goes through a process of confirmation, in which the individual integrates the innovation into his life and recommends it to others.

asset mapping

A component of community capacity assessment and community development that involves conducting an inventory of individual, group and community resources, often physically designating them on a geographical map. A capacity assessment offers an alternative to a needs-based approach to community health and "is a measure of actual and potential individual, group and community resources that can be inherent and/or brought to bear for health maintenance and enhancement." Once assets are "mapped," efforts are directed at mobilizing, strengthening and supplementing them while working to achieve a common vision.

Health Status

A description and/or measurement of the health of an individual or population at a particular point in time against identifiable standards, usually by reference to health indicators.

Motivational Interviewing

A directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence; Emphasizes drawing out an individual's internal motivations to change; allowing an individual to express and resolve her own ambivalence towards a behavior; and avoiding direct persuasion, confrontation and argumentation. The individual is viewed as the expert, while the primary role of the interviewer is to facilitate the individual's expression of goals and the discovery of an acceptable resolution to the ambivalence. In theory, an individual's ambivalence is the principle barrier to behavior change.

Information-motivation-behavior

A general model that holds that information, motivation, and behavioral skills are the primary determinants of health-related behaviors. Individuals who are well informed, highly motivated, and who have the necessary behavioral skills are more likely to engage in a specific health-related behavior. The specific types of information, motivational strategies and behavioral skills necessary to lead to behavior change are expected to vary between subpopulations and between behaviors. Behaviorally relevant information is considered "a necessary but not a sufficient condition" for risk reduction behavior. In general even a well-informed and behaviorally skilled individual must be highly motivated in order to engage in a specific health-promoting behavior and to maintain it over time.

Locus of control

A generalized belief that circumstances and rewards are under one's own (internal) or others' control (external).

Coalition

A group of organizations or representatives of groups within a community joined to pursue a common objective

Social Cognitive Theory

A health behavior theory that describes the reciprocal influence and dynamic interaction between an individual's personal factors, the environment, and specific health behaviors. Major constructs include environments , situations (an individual's cognitive perceptions of the environment that may affect his behavior), behavioral capability , outcome expectations , outcome expectancies (the value an individual places on an expected outcome), self-regulation (ability to engage in goal-directed behavior), observational learning, reinforcements, perceived self-efficacy , emotional coping responses, and reciprocal determinism . It maintains that personal factors within individuals—their behavioral capability, self-efficacy, outcome expectations and expectancies, coping mechanisms, and self control—are key determinants of behavior and both influence and are influenced by the environment. The environment is important partially because it provides models for and opportunities for observational learning and reinforcement, increasing the likelihood that certain behaviors are performed. Based on the concept of reciprocal determinism any change in the person, environment or behavior results in a situational change, necessitating a reevaluation of the interaction between the three.

Community health advisor

A member of the target community that is trained to administer health promotion messages and program activities; Often used to overcome language barriers, to enhance the cultural relevance of health promotion programs, to facilitate access to and understanding of a community among program planners, to help connect members of the target population with services, etc.

Behavioral intention

A mental state in which the individual expects to take a specified action at some time in the future.

Hardiness

A positive coping influence characterized by "high levels of perceived control, commitment to succeed, and a propensity to see stressful life events as challenging." Challenging, in this context, reflects an individual's ability to view stressful situations and experiences as an opportunity for growth and development and not as a threat. Individuals with this characteristic are less likely to experience illness as a result of stressful events.

Consciousness raising

A process of learning new facts, ideas and tips that support the healthy behavior change. Efforts to increase awareness about the causes and consequences of a disease or unhealthy behavior during a media campaign would be considered examples; A process of change included in the Transtheoretical model that is most appropriate for individuals in the earliest stages of change (precontemplation and contemplation).

Intervention mapping

A program planning framework intended to facilitate the development of theory- and evidence-based health promotion programs. Following a thorough review of the literature and an appropriate needs assessment, the process includes five steps: 1) creating matrices of proximal program objectives from performance objectives and determinants of behavior and environmental conditions; 2) selecting theory-based intervention methods and practical strategies; 3) designing and organizing programs; 4) specifying adoption and implementation plans; and 5) generating an evaluation plan. In step one, a list of performance objectives are generated that define the desired behavioral and environmental outcomes of the program; personal (internal) and external determinants of the behavioral and environmental outcomes are specified; if determinants vary by sub-population, the target population is differentiated; and, finally, performance objectives and determinants are linked in a matrix format, often by level (i.e. individual vs. organizational) and by sub-population, if applicable. Each cell in the resulting matrices will contain either a learning objective (linking a performance objective with a personal determinant) or a change objective (linking a performance objective with an external determinant) that defines what individuals need to learn or what changes need to take place in the environment as a result of the program. In step 2, a list of theoretical intervention methods (i.e. community planning) and a list of possible strategies for delivering those methods (i.e. community forums or meetings) are developed, based on the identified proximal objectives. In step 3, the selected strategies are operationalized into deliverable program components and delivery mechanisms (i.e. channel selection), and program materials are developed and pre-tested. During step 4, a "linkage system" between program users and developers is created so that the program can be modified to meet the needs of the users; adoption and implementation performance objectives are developed; determinants of adoption and implementation are specified; and an implementation plan is developed. Finally, step 5 involves developing an evaluation model, including a plan for process evaluation.

Intervention message

A program-specific message delivered to an individual or group that is designed to increase awareness of a health problem, motivate behavior change, address perceived barriers to engaging in a health behavior, or something else related to the goals and objectives of the program. Theory-based and tailored messages are typically the most effective.

Relapse prevention

A self-control program designed to help individuals to anticipate and cope with the problem returning to a negative health behavior. According to this related model which is based on social-cognitive psychology, this is influenced by both immediate determinants and covert antecedents to high-risk situations. Immediate determinants include high-risk situations, coping skills, outcome expectancies, and the abstinence violation effect (the individual's emotional response to an initial lapse and what he attributes that lapse to). Covert antecedents to high-risk situations—lifestyle factors (i.e. stress and lifestyle imbalance) or cognitive factors such as cravings and urges—can increase the likelihood of this by increasing an individual's exposure to high-risk situations and/or by decreasing the individual's motivations to returning to the behavior. The related model outlines various intervention strategies for identifying, preventing, or avoiding the determinants and antecedent causes.

Empowerment

A social action process that promotes participation of people, organizations and communities in gaining control over their lives in their community and larger society. With this perspective, it is not characterized as achieving power to dominate others, but rather power to act with others to affect change.; In health promotion,it is a process through which people gain greater control over decisions and actions affecting their health.

Community

A specific group of people, often living in a defined geographical area, who share a common culture, values and norms, are arranged in a social structure according to relationships which have been developed over a period of time. Members gain their personal and social identity by sharing common beliefs, values and norms which have been developed in the past and may be modified in the future. They exhibit some awareness of their identity as a group, and share common needs and a commitment to meeting them.

Behavioral objective

A statement of desired outcome that indicates who is to demonstrate how much of what action by when.

Health Insurance Portability and Accountability Act (HIPAA)

A statute passed in 1996 in efforts to improve the efficiency of healthcare delivery by mandating and standardizing the electronic exchange of health information and to provide Federal protections to preserve the privacy of protected, individually identifiable health information. Under this acts Privacy Rule, which has been effective since April, 2003, an individual has the right to see and correct his health records, to know how information from those health records is being used and shared, and to deny permission for those health records to be used for certain purposes. In many cases, an individual must provide written permission for certain individuals or groups to be able to received information from his personal health records, unless that information is needed to provide continuity of care or is required to be reported for public health surveillance purposes.

Behavioral risk

A typically modifiable behavior, like smoking or lack of physical activity, which puts an individual at risk for a negative health outcome.

Gatekeeper

An individual who formally or informally controls aspects of a community and/or access to a priority population; Typically very knowledgeable of a community and how it functions. In community health, gaining their cooperation can improve the feasibility, quality and acceptability of community interventions and programs.

Perceived self-efficacy

An individual's beliefs about and confidence in his ability to perform a certain behavior or take action; Influences what behaviors we choose to perform, the amount of effort we expend on performing those behaviors, how long we persist in performing a behavior, and how we feel about particular behaviors; Developed through direct or vicarious experience, verbal or social persuasion, and physiological reactions/feedback; Concept common to many theories of Health Behavior, but is most directly related to Social Cognitive Theory.

Perceived severity

An individual's beliefs about how serious a disease or its physical and social consequences are; Key construct of the Health Belief Model.

Perceived susceptibility

An individual's beliefs about how vulnerable, or at risk, he or she is to getting a particular disease or of being affected by a particular health outcome; Key construct of the Health Belief Model.

Perceived benefits

An individual's beliefs about the efficacy of a particular behavior in reducing the perceived threat associated with a particular disease or outcome. An individual would not be expected to adopt a specific health behavior without believing it would effectively reduce his perceived threat of disease; Key construct of the Health Belief Model.

Perceived barriers

An individual's beliefs about the negative consequences of or challenges associated with engaging in a particular health behavior. Can be physical, emotional, psychological, economic, etc. Typically, the perceived benefits of a behavior must outweigh these for a person to adopt that behavior; Key construct of the Health Belief Model.

Behavioral capability

An individual's knowledge and skills related to a specific health behavior. In order for an individual to engage in a particular behavior, that individual must first know what the behavior is and how to successfully perform it. Key construct of the Social Cognitive Theory.

Health Belief Model

An individual-level, value-expectancy health behavior theory developed in the 1950s by social psychologists in the U.S. Public Health Service in efforts to explain why people did not seek preventive health and screening services. The theory was first used in relation to a free Tuberculosis screening program, but has since been applied to numerous health behaviors; Maintains that an individual will engage in behavior to prevent, screen for or control disease or negative health outcomes if they 1) perceive themselves to be at risk for that disease; 2) believe that the disease has potentially serious consequences; 3) believe that a recommended (and available) behavior is effective in reducing their risk for or the consequences of the disease; and 4) believe that the perceived barriers or costs of engaging in that behavior are fewer than the perceived benefits. Internal or external cues to action can motivate a person to take action. Self-efficacy was added as a construct in the late 1980s.

Harm reduction

An intermediate approach to behavior change that emphasizes adopting a lower risk alternative to a high risk behavior when an individual is either unwilling or unable to stop the high risk behavior. Needle exchange programs that facilitate the use of sterile injection equipment in order to reduce the transmission of HIV among injection drug-users are an example.

Outcome expectations

Anticipatory outcomes of a behavior or what an individual perceives is the likely result of engaging in a specific behavior; Develop from previous experience, through observing others, hearing about specific behaviors or situations from others, or from emotional or physical responses to a behavior; Construct of the Social Cognitive Theory.

Formative evaluation

Any combination of measurements obtained and judgments made before or during the implementation of materials, methods, activities or programs to discover, predict, control, ensure, or improve the quality of performance or delivery." This can include the combination of needs assessment, pilot testing, process evaluation, etc.

Process evaluation

Any combination of measurements obtained during the implementation of program activities to control, assure, or improve the quality of performance or delivery.

Quasi-experimental design

Any research design that does not use randomization in assigning units (individuals) to conditions or treatments; Depend on self-selection or administrator selection to assign individuals to conditions but they are otherwise structurally similar to a randomized experimental design.

Formative research

Assesses the nature of the problem, the needs of the target audience, and the implementation process to inform and improve program design; Conducted both prior to and during program development to adapt the program to audience needs. Common methods include literature reviews, reviews of existing programs, and surveys, interviews, and focus group discussions with members of the target audience.

Outcome evaluation

Assessment of the effects of a program on the ultimate objectives, including changes in health and social benefits or quality of life.

Perceived response efficacy

Belief whether the recommended action is effective in preventing or reducing risk for a health problem. It is important to note that ether low perceptions of self (self efficacy), or low perceptions of the recommended action may lead to maladaptive behavior. For example, people may not feel confident that they can reduce their intake of fried foods (self efficacy) or they may not feel confident that reducing their intake of fried foods will lower their risk of heart attack. The implication for prevention is to ensure that health education supports both the belief in one's ability to change lifestyle behaviors as well as the belief that lifestyle changes are effective in reducing risks.

Predictors

Characteristics or variables that help to explain a particular behavioral, health or other outcome.

adherence

Closely following or sticking to a plan or protocol. In the context of health promotion, we use the term adherence to refer to individuals taking their medications as prescribed (i.e. adherence to antiretroviral therapy) or following program protocols (i.e. sticking to a diet and exercise plan). In the context of health promotion, adherence can also refer to following the implementation protocol when delivering a health promotion program, conducting interviews, etc.

Community capacity

Combined assets that influence a community's commitment, resources, and skills used to solve problems and strengthen the quality of life for its citizens.

Population-based

Community health methods that are used to help change behavior in groups of people. These approaches use a defined community as their organizing principle for preventive action over individuals, and they focus on addressing population-level processes that influence health. Examples include policy development and advocacy, organizational change, community development and empowerment.

Primary data

Data gathered directly by the individual using it to answer a specified research question or to gather information on a specific population or health problem. This includes data collected first-hand through survey research, focus groups, interviews, etc.

Self-report data

Data that are generated by having respondents report about themselves. Common in sociaorgal and behavioral sciences, but their validity is often questioned because of potential bias.

Psychological determinants

Determinants of health that reflect the interaction between the social environment and an individual's development, beliefs and behaviors. These factors are thought to not only mediate the effects of social and structural factors on individual health outcomes, but also to be influenced by the social structures and contexts in which they develop. Coping skills or social support following a stressful experience are examples.

Health disparities

Differences in the incidence, prevalence, mortality, burden of diseases or other adverse health conditions that exist among specific groups within the general population; A chain of events signified by a difference in: (1) environment, (2) access to, utilization of, and quality of care, (3) health status, or (4) a particular health outcome that deserves scrutiny.

Risk communication

Engaging communities in discussions about environmental and other health risks and about approaches to deal with them. Also includes individual counseling about genetic risks and consequent choices.

Ethics in health promotion and health promotion research

Ethical principles in health education and health promotion practice and research are similar to those outlined in the Belmont Report and earlier ethical codes and include principles of respect for persons, beneficence, and justice. In health promotion practice and research, these ethical principles call for informed consent and voluntary participation, a commitment to preserve participant privacy, equitable inclusion in programs and research, a protection of vulnerable populations, and careful efforts to maximize benefits and minimize risks for participants. A unified code of ethics for the health education profession was adopted in 1999, outlining each health educator's responsibilities to the public, to the profession, to employers, in delivering health education, in conducting research and evaluation, and in professional preparation.

Protective factors

Factors that decrease the likelihood of negative health outcomes and risk behaviors.

acculturation

Gradual process through which an individual adopts the behavioral norms, attitudes and beliefs of a culture other than his own

Co-morbidity

Having more than one illness or condition that compromises quality of life at the same time.

Change agent

In the context of Diffusion of Innovations, this is "an individual who influences clients' innovation-decisions in a direction deemed desirable by an agency." Functions are often to develop a perceived need for change, facilitate information-exchange, identify a client's problems, develop a client's intentions to change, motivate the movement from intentions to action, support long-term adoption of the change, and help the client achieve self-reliance.

Communication Theories

In the context of public health, these theories are meant to describe how communication processes impact health behavior change and how communication strategies can be used strategically to motivate behavior change. Although there are a number of these theories and concepts, four that are particularly relevant to public health include the knowledge gap, agenda setting, cultivation studies, and risk communication . The knowledge gap refers to the fact that individuals with more formal education tend to be more knowledgeable about many issues when compared to those with less formal education; therefore, "an increasing flow of information into a social system is more likely to benefit groups of higher socioeconomic status than those of lower SES," thereby contributing to health disparities and other inequities. Knowledge gaps can be modified by content and channel factors, social conflict and mobilization, community structure, and individual motivational factors. Agenda-setting refers to the ability of the mass media to influence public opinion and priorities, particularly in relation to politics and policymaking. Cultivation studies investigate "the impact the mass media have on our perceptions of reality.

Predisposing factors

Include a person's or population's knowledge, attitudes, beliefs, values and perceptions that facilitate or hinder motivation for change; part of Precede-Proceed framework

Opinion Leaders

Individuals who are well respected in a community and can accurately represent the views of the priority population. They are typically demographically similar to the priority population, knowledgeable about community issues and concerns, early adopters of innovations, and capable of persuading others to engage in a particular behavior.

Feedback

Information provided to individuals based on their individual characteristics or based on comparisons with others. Major types, in the context of health communication and communication technology, include personal, normative, and ipsative (or iterative). Personal "refers to the information that respondents obtain about the answers they have provided." Normative "refers to the information respondents obtain when comparing their responses with the responses of another group." Ipsative "refers to a comparison between a person's most recent status and that found at previous assessments."

Institutionalization

Involves "permanently" incorporating program activities into the routines and structure of an organization or community in order to maximize the long-term benefits of your program and to ensure its sustainability following staffing changes, the termination of formal activities and/or grant funding, etc.

Pilot testing

Involves implementing a program or program components on a smaller scale, in a setting similar to where the program will be fully implemented and with a population similar to the planned target population; Allows program planners to identify and correct problems with the intervention strategies before they are fully implemented.

Secondary data

Pre-existing data collected by somebody other than the individual using it. Often used in conducting needs assessments and/or to supplement primary data.

Secondary prevention

Preventive measures that are directed at the early diagnosis and treatment of injuries and diseases to limit disability and prevent the development of complications and more serious disease. Screening tests and self-exams for breast cancer are examples.

Evidence-based practice

Program decisions or intervention selections made on the strength of data from the community concerning needs and data from previously tested interventions or programs concerning their effectiveness, sometimes using theory in the absence of data on the specific alignment of interventions and population needs.

Community-based interventions

Programs designed to focus on healthful changes in either subgroups or localized populations.

Best practices

Recommendations for an intervention, based on a critical review of multiple research and evaluation studies that substantiate the efficacy of the intervention in the populations and circumstances in which the studies were done, if not its effectiveness in other populations and situations where it might be implemented.

Primary prevention

Refers to preventive measures that are intended to prevent or put off the onset of injury or disease. Vaccinations, abstinence, and exercise are examples.

Normative beliefs

Reflect individuals' beliefs about whether important referent individuals, or people whose opinion they value, approve or disapprove of a particular behavior; These, along with an individual's motivation to comply with the opinions and values of the referent individuals, form a person's subjective norms; These and subjective norms are constructs of the Theory of Reasoned Action/Theory of Planned Behavior.

Levels of prevention

Reflect the different points of prevention and intervention in health education and health promotion.

Social capital

Represents the degree of social cohesion which exists in communities. It refers to the processes between people which establish networks , norms, and social trust, and facilitate co-ordination and co-operation for mutual benefit."; "usually characterized by four interrelated constructs: trust, cooperation, civic engagement, and reciprocity."

Screening behavior

Seeking diagnostic tests to check for the presence of disease or precursors to disease, typically prior to the development of outward signs and symptoms. Facilitate early diagnosis of disease and often improve disease outcomes.

Environment/environmental factors

Something that influences an individual's behavior but is physically external to the individual; Are explicitly important in social ecological approaches to health education and health promotion, as well as in Social Cognitive Theory.

Mediating factors

Something that partially or completely explains the relationship between a predictor and a behavior or outcome; Independently related to the outcome of interest and to the predictor of interest, thereby acting as a link between the two. In the Theory of Reasoned Action, a person's behavioral intention acts in this role between his attitude and subjective norms and his behavior.

Risk behavior

Specific forms of behavior which are proven to be associated with increased susceptibility to a specific disease or ill-health.

Cues to action

Strategies to activate one's readiness to engage in a particular behavior or activity; Can be either an internal or external stimulus that motivates a person to act. Key construct in the Health Belief Model.

National health objectives

The U.S. Department of Health and Human Services has coordinated a process to develop this to direct public health efforts each decade since 1980, starting with the publication of Promoting Health/Preventing Disease: Objectives for the Nation. The current set of is contained in Healthy People 2010: Understanding and Improving Health . Healthy People 2010 contains 467 national health objectives that cover 28 primary focus areas.

Policy advocacy

The actions or endeavors individuals or groups engage in in order to alter public opinion in favor or in opposition to a certain policy.

Impact evaluation

The assessment of program effects on intermediate objectives including changes in predisposing, enabling, and reinforcing factors, behavioral and environmental changes, and possibly health and social outcomes.

Perceived threat

The combination of perceived severity and perceived susceptibility. An individual's beliefs about his perceived susceptibility to a disease and the perceived severity of that disease combine to form his overall beliefs about the level of harm that the disease poses for him.

Evaluation

The comparison of an object of interest against a standard of acceptability." In health education and health promotion, it is typically thought about in three distinct phases: formative, process and summative.

Processes of change

The covert and overt activities that people use to progress through the stages of change in the transtheoretical model (TTM). There are ten of these that have been identified in conjunction with the development of the TTM: consciousness raising, dramatic relief, self-reevaluation, environmental reevaluation, self-liberation, helping relationships, counter-conditioning, contingency management, stimulus control, and social liberation. Different ones are used by individuals in different stages of change to progress towards action and maintenance. In the early stages, people tend to rely more on the cognitive, affective and evaluative processes (consciousness raising, dramatic relief, environmental reevaluation and self-reevaluation) while in the later stages the emphasized processes of change focus on making commitments, seeking support, contingency planning and other behavioral processes (counter-conditioning, helping relationship, stimulus control, reinforcement management).

Health literacy

The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.

Cultural competence

The design, implementation, and evaluation process that accounts for special issues of select population groups (ethnic and racial, linguistic) as well as differing educational levels and physical abilities.

Reciprocal determinism

The dynamic interaction of the person, behavior, and the environment in which the behavior is performed; Emphasizes that health behaviors and individuals are not only influenced by the physical and social context in which they exist, but also that such individuals and their behavior influences the environment; Key construct of the Social Cognitive Theory and in ecological approaches to health promotion.

Precede-Proceed Framework

The most well-known health program planning model. A program planner begins by identifying the desired outcome of the program and working backwards to discover strategies for reaching that outcome. PRECEDE stands for p redisposing, r einforcing and e nabling c onstructs in e ducational/ecological d iagnosis and e valuation, and includes various stages of assessment and planning. PROCEED stands for p olicy, r egulatory, and o rganizational c onstructs in e ducational and e nvironmental d evelopment and deals mainly with program implementation and evaluation. PRECEDE-PROCEED has six main phases, followed by three phases of evaluation: Phase 1, social assessment and situational analysis, involves engaging the target population to identify general indicators of quality of life. Phase 2, epidemiological assessment, includes identifying specific health goals or problems that contribute to or interact with the social goals or problems identified in phase 1. Phase 3, behavioral and environmental assessment, involves identifying and prioritizing behavioral and environmental determinants of the specific health problems identified in phase 2. Phase 4, educational and ecological assessment, includes identifying and prioritizing predisposing, reinforcing and enabling factors that are related to the behavioral and environmental determinants.Phase 5, intervention alignment and administrative and policy assessment, involves intervention matching, mapping, and patching to determine which program components and activities are needed to target the factors identified in the previous stages and determining whether or not the program has the policy, organizational and administrative capacity to do them. In phase 6, implementation occurs. Phase 7 includes process evaluation, phase 8 includes impact evaluation, and phase 9 includes outcome evaluation.

Behavioral factors

The patterns of behavior of individuals and groups that protect or put them at risk for a given health or social problem.

Quality of life

The perception of individuals or groups that their needs are being satisfied and that they are not being denied opportunities to achieve happiness and fulfillment.

Resilience

The process of adapting well in the face of adversity, trauma, tragedy, threats, or even significant sources of stress—such as family and relationship problems, serious health problems, or workplace and financial stressors.

Needs assessment

The process of determining, analyzing and prioritizing needs, and in turn, identifying and implementing solution strategies to resolve high priority needs; Meant to assist program planners in identifying a priority population, their specific needs, subgroups of the population with the greatest needs, the most significant problems facing the priority populations and subgroups, what is currently being done and/or what has been done in the past to effectively address their needs, etc.; Generally viewed as the first step in health promotion program planning and depends on both secondary and primary data collection gathered through a variety of qualitative and quantitative methods.

Self-management

The process of taking an active responsibility for and control over managing and monitoring one's health.

Decisional Balance

The relative weight an individual places on the perceived pros and cons of changing or engaging in a certain behavior. Typically, the pros of change need to outweigh the cons of change before an individual will be ready to take action and maintain a behavior change; Key construct in the Transtheoretical model.

Reinforcing factors

The rewards received and the feedback the learner receives from others following adoption of a behavior; part of Precede-Proceed framework

Community organization

The set of procedures and processes by which a population and its institutions mobilize and coordinate resources to solve a mutual problem or to pursue mutual goals.

Mixed methods

The strategic and systematic combination of qualitative and quantitative research methods. The combination of methods often works to overcome the limitations of quantitative or qualitative methods used in isolation, to improve the validity of findings, and/or to provide a more comprehensive understanding of a problem or phenomenon.

Perceived outcome expectations

The value an individual places on an expected outcome; construct of SCT

Ecological approaches/levels

These recognize the multiple levels of influence on and the varying nature of determinants of health. They view health behavior as both affected by and affecting the physical and social environment (reciprocal determinism). They move beyond a "victim blaming," and emphasize the use of multiple strategies to impact determinants of health, partnerships between multiple sectors to enhance health promotion efforts, and targeting change at multiple levels of intervention. The levels of these in health promotion include intrapersonal factors, interpersonal processes and primary groups, institutional factors, community factors, and public policy.

Mission statement

This briefly define the purpose and focus and sometimes the vision and values of an organization or program. Typically, all program planning, program activities, partnerships, etc. should be made to reflect this to ensure that they are in line with the overall purpose and goals of the program or organization.

Early adopters

Those in the population who accept a new idea or practice soon after the innovators (but before the middle majority), and who tend to be opinion leaders for the middle majority.

Enabling factors

Those skills, resources or barriers that can help or hinder the desired behavioral changes as well as environmental changes; part of Precede-Proceed Framework

Quantitative research

Utilizes methods that result in the collection of numerical and typically predefined data. Statistical methods are employed to analyze and interpret quantitative data. Closed-ended surveys are an example.

Qualitative research

Utilizes methods that results in the collection of non-numeric data that are not highly categorized or defined prior to data collection. Open-ended surveys, focus groups, in-depth interviews, observational and case studies are examples.