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Behavioral Theory in a Diverse Society: Like a Compass on MarsHelen Diller Family Comprehensive Cancer Center, University of California, San Francisco, rpasick{at}cc.ucsf.edu
Diller Family Comprehensive Cancer Center and Department of Anthropology, History, and Social Medicine, University of California, San Francisco
Department of Anthropology, History, and Social Medicine, University of California, San Francisco
Department of Anthropology, History, and Social Medicine, University of California, San Francisco
Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco
Institute for Health and Aging, University of California, San Francisco
Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco
Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco
Department of Community Health, Brown University, Providence, Rhode Island
Department of Community Health, Brown University, Providence, Rhode Island
School of Public Health, University of California, Berkeley
Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco The behavioral theory constructs most often used to study mammography utilization—perceived benefit, perceived susceptibility, self-efficacy, intention, and subjective norms—have neither been developed nor sufficiently tested among diverse racial/ethnic subgroups. The authors explored these constructs and their underlying assumptions relating to the social context of Filipina and Latina women. The mixed-methods study included testing construct measures in the multilingual surveys of a concurrent intervention study of 1,463 women from five ethnic groups. An intensive inductive investigation then targeted Latina and Filipina women to elucidate connections between social context and individual screening behavior. In-depth interviews were conducted with 11 key informant scholars, 13 community gatekeepers, and 29 lay women, and a supplemental study videotaped and interviewed 9 mother—daughter dyads. Three social context domains emerged: relational culture, social capital, and transculturation and transmigration. The meaning and appropriateness of the five behavioral constructs were analyzed in relation to these domains. In contradistinction to tenets of behavioral theory, the authors found that social context can influence behavior directly, circumventing or attenuating the influence of individual beliefs; contextual influences, synthesized from multiple p erspectives, can operate at an unconscious level not accessible to the individual; and contextual influences are dynamic, contingent on distal and proximal forces coming together in a given moment and are thus not consistent with an exclusive focus at the individual level. This article describes the study methods, summarizes main findings, and previews the detailed results presented in the other articles in this issue.
Key Words: behavioral theory • culture • social context • mixed methods • mammography
Health Education & Behavior, Vol. 36, No. 5 Suppl,
11S-35S (2009) This article has been cited by other articles:
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