Primary author:__
Fatima Warsame
Yearly, millions of people die from preventative illnesses, a large portion due to negative personal behaviors (Elder, 1987). Negative personal behaviors, such as cigarette smoking are linked to many chronic diseases, like Heart Disease, Cancer, Hypertension, causing countless deaths, while risky sexual behaviors contribute to the significance of deadly epidemics, such as AIDS (Reynolds , Elizabeth et al 2010). A large obstacle to public health intervention programs is the role of individual personal behaviors hindering health advancement. Realizing the important implications of personal behavior on health, over the years many behavioral intervention theories have been proposed, among them, the prominent theory of Social action, from the American Sociologist, Talcott Parsons (Camic, Charles 1998). Social action theory expands on individual based psychological theories and considers the larger contextual factors in influencing behavior (Reynolds , Elizabeth et al 2010). In this theory, the self-regulation process of the individual is analyzed, within the context of environmental factors for the purpose of noting how both the internal and external factors influence individual action or health behavior (Reynolds , Elizabeth et al 2010). The goal of social action theory is to identify influencing personal behaviors and in doing so, manipulate environmental and self-regulatory factors which can promote or hinder health habits (Johnson, Carrico et al. 2008). Social action theory has been an ideal model for public health intervention programs, because it addresses individual determinants as well as the social and environmental determinants which affect a health issue.

One such public health intervention, utilizing SAT has been with HIV risk reduction. When applied to risky sexual behaviors, SAT analyzes the influences of personal regulatory resources, the individual’s psychopathology, HIV-related attitudes and knowledge, self-regulatory skills, and the environment on risky sexual behaviors (Reynolds , Elizabeth et al 2010). In analyzing individual factors, as well as the external factors that influence individual behavior, SAT offers a framework which gives public health intervention programs a factual assessment of the multiple complex factors that influence behaviors and thus health outcomes. Social Action theory (SAT) states that people are driven by a purpose, guided by personal interests and thus are goal orientated. (Ewart, Craig 2009). This theory explains a person’s goals and their means of problem solving produce routine action patterns that continue over an extended period of time (Ewart, Craig 2009). Therefore, it is useful in applying SAT to behavioral change in identifying an individual’s action patterns, their goals and their approach to problem solving to introduce new action patterns, goals and a better approach to problem solving (Ewart, Craig 2009). The goal of this approach is to identify and eliminate factors that contribute to negative health behaviors, which are detrimental to good health and introduce positive health behaviors, which will enhance good health (Reynolds, Elizabeth et al 2010, Ewart, Craig 2009). Change is attained through a goal orientated action, which involves outlining the desired habit, devising a plan to acquire that habit and continuing upon this plan as part of a daily routine, until the desired habit is achieved (Ewart, Craig 2009). Furthermore, Social action theory takes into account how individual goals and problem solving strategies can be influenced by both physical and social environments (Ewart, Craig 2009). In doing so, SAT provides an analysis on how the environment can shape an individual’s self-regulation plan for change and moreover how this can either hinder or enhance health (Ewart, Craig 2009). In placing an individual’s personal action within an environmental perspective, SAT produces a realistic approach to behavioral change.

Within the Social action theory model, habitual change begins by identifying the habitual routines which are detrimental to health and the healthier routines that can replace them (Ewart, Craig 2009). An example is identifying a sugary candy bar as a snack for everyday as unhealthy and replacing this daily routine with a fruit as the healthier option. In this case, the health damaging habit was identified and replaced with a desired habit to enhance health. However, it is not always easy to employ social action theory to change negative personal habits. As was mentioned previously, the environment is a significant regulator when it comes to individual behaviors. Individual behaviors are part of daily routines, which are shaped by one’s environment. (Ewart, Craig 2009). For example, eating that sweet candy bar can be attractive, due to the familiarity of eating a candy bar routinely and not being used to eating a fruit. Successful intervention in modifying negative behavior begins with specifically identifying the negative behavior, its negative health outcomes and thus avoiding the conditions both internal and external that can trigger that negative behavior (Ewart, Craig 2009).

Unhealthy behaviors do produce instant gratifying outcomes, which are often times triggered by biological and social cues (Ewart, Craig 2009). Smoking a cigarette or eating a candy bar can for example provide instant gratification for an individual or allow a person to connect socially with others (Ewart, Craig 2009). Therefore, changing these unhealthy habits can be uncomfortable and disruptive for an individual. Social action theory recognizes this challenge and proposes the need for strong positive rewards, when enforcing healthy behavioral changes, in order to sustain the desired health outcome (Ewart, Craig 2009). SAT encourages public health promoters to interpret behaviors as a sequence of routine habits linked to physical and social environments and not as isolated events. Moreover the theory establishes the need to have immediate rewarding outcomes to maintain the desired health outcome over the long term (Ewart, Craig 2009). SAT identifies personal and environmental factors that can shape the individual’s goals, social interactions, problem solving, self efficacy and projected outcomes which can either enhance or hinder behavioral change (Ewart, Craig 2009). Due to the strengthens of this theory in identifying the relationship of individual and environmental factors that shape behavior, it has been implemented to address public health challenges such as heart disease, spread of HIV, inadequate nutrition, drug abuse and as a result advancing health.


References:
Camic, Charles (1998). Reconstructing the Theory of Action. Sociological Theory. 16 (3). 283-291

Elder, J. E (1987). Applications of behavior modification to health promotion in the developing world. Social Science and Medicine. 24 (4). 335-349.

Ewart, Craig. (2009). Changing our unhealthy Ways: Emerging Perspectives from Social Action Theory. DiClemente, Ralph, Crosby, Richard, Kegler, Michelle (Eds). Emerging Theories in Health Promotion Practice and Research. (pp. 359-386). (2nd ed.). San Francisco: Josseys-Bass.

Johnson, M. O., Carrico, A. W., Chesney, M. A., & Morin. S. F. (2008). Internalized heterosexism among HIV-positive gay-identified men: Implications for HIV prevention and care. Journal of Consulting and Clinical Psychology, 76, 829–39

Reynolds, K Elizabeth, Magidson, F Jessica, Bornovalova A. Marina , Gwadz, Marya, Ewart, K. Craig (2010). Application of the Social Action Theory to Understand Factors Associated With Risky Sexual Behavior Among Individuals in Residential Substance Abuse Treatment. American Psychological Association. Retrieved November 17, 2010 from http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=5&hid=9&sid=a5beb66a-765f-4fcb-96f1-d5cb35de2896%40sessionmgr10