Paper
Saturday, November 3, 2007
658
A Multi-Level Perspective to the Design of Theory-based Intervention
Julie Derenowski Fleury, PhD, FAAN, College of Nursing, Arizona State University, Phoenix, AZ, USA
Optimizing health outcomes is intrinsically linked with health promotion efforts targeting the prevention and management of chronic illness. The limits of current research in addressing social contextual factors may contribute to the lack of success in developing relevant theoretical models designed to promote health outcomes. The extent to which health promotion research focuses on individuals and individual choices in isolation, and ignores the social context of health-related behaviors, may significantly impact the extent to which we are able to reach specific groups within society. Thus, the challenge for researchers and clinicians includes the development of effective interventions that target health outcomes at both the individual and community levels. Given the complexity of behavior, conceptual perspectives designed to promote health outcomes are needed that provide a better understanding of the relationship among social, contextual, and motivational variables.
This paper will describe the use of an integrated framework, based on the wellness motivation theory and the social ecological perspective, to conceptualize the problem addressed by the intervention, develop culturally relevant intervention strategies, operationalize health outcomes as incorporating the individual in interaction with the environment, and propose mechanisms by which access to social and contextual resources may influence health outcomes. The multi-level perspective represents an integrative effort to foster capacity and resource sustainability consistent with community-level change, and to advance individual-level change through the process of constructing and using knowledge, motivation, and relationships. The integration of the social ecological perspective and wellness motivation theory enhances the specificity of treatment in targeting intrapersonal, interpersonal, community and environmental levels of influence, characterized as the mediating processes through which specified behavioral and health outcomes are achieved.
Funded by: American Heart Association Patient Care Outcomes Initiative # 9970022N