Theories in Our Work
Public Health Perspective
HEARTS for Families has adopted the Public Health Perspective in Health Promotion, Health Education and Behavior Change to improve nurturing parenting as a protective factor against substance abuse and child abuse. Parenting is a determinate of health for children, and as with other social determinants of health, institutions and organizations addressing social determinants of health must utilize public health strategies and strong theoretical approaches to effectively and efficiently address this social concern.
HEARTS addresses parenting as a protective factor for community change through community capacity building, workshops, training, and parenting programs with the long term goal to move into policy change and environmental reinforcements to support nurturing parenting practices. We offer a variety of programming with varied intensity levels, to address the various need and penetration levels needed to create a public health approach.
Health promotion, health education and behavior change strategies have been proven to work in the prevention of substance abuse and child maltreatment by focusing on multiple or co-occurring risk factors. Substance abuse and child maltreatment have similar risk and protective factors that often go beyond the individual’s influence or actions. The environment has a strong influence on the focused behavior change which is why HEARTS is intentional in its approach to address the family “unit” and the community in which the individual resides.
The two main theories utilized by HEARTS are the social learning or social cognitive theory and the ecological approach. The social learning theory:
“…proposes that behavior change is affected by environmental influences, personal factors, and attributes of the behavior itself. Each may affect or be affected by either of the other two. A central tenet of social cognitive theory is the concept of self-efficacy. A person must believe in his or her capability to perform the behavior and must perceive an incentive to do so (i.e., the person's positive expectations from performing the behavior must outweigh the negative expectations). Additionally, a person must value the outcomes or consequences that he or she believes will occur as a result of performing a specific behavior or action. Outcomes may be classified as having immediate benefits. But because these expected out-comes are filtered through a person's expectations or perceptions of being able to perform the behavior in the first place, self-efficacy is believed to be the single most important characteristic that determines a person's behavior change. Self-efficacy can be increased in several ways, among them by providing clear instructions, providing the opportunity for skill development or training, and modeling the desired behavior. To be effective, models must evoke trust, admiration, and respect from the observer; models must not, however, appear to represent a level of behavior that the observer is unable to visualize attaining.”The following is a description of the ecological approach. It is often used in physical activity initiatives; however the public health principles still apply even though further research is needed:
http://www.csupomona.edu/~jvgrizzell/best_practices/bctheory.html
“An underlying theme of ecological perspectives is that the most effective interventions occur on multiple levels. A model has been proposed that encompasses several levels of influences on health behaviors: intrapersonal factors, interpersonal and group factors, institutional factors, community factors, and public policy. Similarly, another model has three levels (individual, organizational, and governmental) in four settings (schools, worksites, health care institutions, and communities). Interventions that simultaneously influence these multiple levels and multiple settings may be expected to lead to greater and longer-lasting changes and maintenance of existing health-promoting habits. This is a promising area for the design of future intervention research to promote physical activity.” http://www.csupomona.edu/~jvgrizzell/best_practices/bctheory.html
The social learning or social cognitive theory focuses on the environmental affects as well as the individual but strongly supports the self efficacy of the individual as a major tenant to the theory. The ecological perspective recognizes that the interventions have to exist on multiple levels to achieve population behavior change. HEARTS is committed to combining micro and macro level approaches to address parenting as a public health concern.