HD535 Unit 2 Theory Selection Paper Example

Fear Is Already at the Ceiling: A Unit 2 Theory Selection Paper Choosing Social Cognitive Theory for Caregiver Epinephrine Skills

[Student Name]

Purdue University Global

HD535: Health Education Program Planning

Unit 2 Theory Selection Paper

[Instructor Name]

[Date]

The neighborhood, the health center and the survey are composite; the theories and studies cited are real.

The Behavior

Choosing a theory starts with defining the behavior it must explain. The target behavior has three parts. A parent, grandparent or regular sitter of a child aged two to twelve with a prescribed epinephrine auto-injector will complete two hands-on practice sessions; will keep two unexpired injectors with the child wherever the child goes; and, at the first signs of a severe reaction, will inject before calling 911 rather than waiting for help.

This behavior is a skill performed rarely and under fear, with equipment that has to be bought, refilled and carried. Any theory chosen needs to explain both whether people act and whether they can.

The Population and the Evidence

Heights Community Health Center serves about [412] children with a documented food allergy and a prescribed auto-injector, most of them covered by Medicaid. Its listening survey of 236 households gives the evidence both theories are tested against. Eighty-six percent of caregivers rated a severe reaction very serious, and 79 percent believed their child could have one in the coming year. Eighty-eight percent agreed that epinephrine saves lives. Yet 61 percent had never handled a trainer, 44 percent said they would call 911 first and wait for instructions, and only 47 percent had two unexpired injectors at home. About a third of children spend after-school hours with a grandparent or sitter who had never been shown the device.

The Rival: Belief-Based Change

The Health Belief Model is the obvious first candidate for a frightening, preventable hazard. Its core claim is that action follows when a person feels personally at risk of a serious threat, believe that action will help, see few barriers and meet a cue to act (Rosenstock, 1974). Self-efficacy was added to the model later.

It deserves a fair hearing. Barriers are real here, and cues, such as a school's medication form each August, could prompt refills.

The survey, however, leaves the model's main levers with little to move. Perceived severity is near its ceiling at 86 percent. Perceived susceptibility is high at 79 percent. Perceived benefits are near universal. A program built on the model would spend most of its effort raising beliefs that are already high. Barriers remain, but the barriers caregivers named were not beliefs about the injector; they were not knowing how to use it, fear of hurting the child, a pharmacy out of stock, and a grandparent who had never been shown. The model has a place for barriers but little to say about how to remove them.

When caregivers already fear the reaction, believe their child is at risk and trust the drug, a theory built around changing those beliefs has spent its energy before the program begins.

The Stronger Fit: Social Cognitive Theory

In Social Cognitive Theory, what people do, what they believe about their own abilities and the settings around them shape one another continuously (Bandura, 2004). Its constructs match the survey directly.

Self-efficacy. Caregivers who have never held a trainer have no mastery experience, the strongest source of confidence (Bandura, 1977). Practicing until injections feel routine addresses this directly.

Behavioral capability. Knowing epinephrine works is different from knowing where to press, how long to hold and what signs mean "now." Studies of device use find many families make errors (Sicherer et al., 2000).

Observational learning and modeling. Watching a caregiver from the same neighborhood describe using an injector on their own child shows the act is possible for someone like them.

Outcome expectations. The 44 percent who would call first may expect that injecting without a professional is dangerous; showing what happens after an injection can change that.

Environment. Pharmacy stock, refill costs, prior authorization and which adult is present are all features of the situation the theory asks planners to change, not just to note.

Self-regulation. Keeping two unexpired injectors in the bag is a routine that needs monitoring and reminders.

What Each Theory Would Have Built

One way to test a theory choice is to imagine the program each framework would produce. A plan built on the Health Belief Model would likely center on messages: stories of children who had severe reactions, statistics on how common they are, reminders that epinephrine works and prompts when school forms arrive in August. Every one of those messages would speak to beliefs caregivers already hold. A grandparent who is afraid of the needle would hear again that reactions are dangerous and still not know where to press.

A plan built on Social Cognitive Theory looks different. Its sessions are spent holding a trainer, practicing until the act is routine, watching a neighbor describe doing it for real and leaving with a second trainer for the sitter. Its staff include a pharmacy navigator, because the theory treats an empty pharmacy shelf as part of the behavior's environment. The contrast shows that the theory decides what the program spends its hours on.

Limits of the Choice

Social Cognitive Theory has weaknesses of its own. It is broad, and a planner can attach almost any activity to one of its many constructs. To guard against that, the plan limits itself to six constructs and requires each activity to name one with a mechanism. The theory also says less about the fear some mothers described of being judged when they call for help after a reaction. The plan treats that fear as an outcome expectation and an environmental barrier, and it will test whether a visit from a paramedic changes it.

Why Not Both?

Combining the two theories was considered. The Health Belief Model's cue to action could support refills timed to school forms. But merging frameworks tends to produce a plan that cites many constructs and measures none well. The cue is kept as a practical activity, a reminder text, which Social Cognitive Theory can describe as a self-regulation support.

The Role of PRECEDE-PROCEED

PRECEDE-PROCEED appears in this plan only as the planning scaffold (Green & Kreuter, 2005). Its predisposing, enabling and reinforcing factors organize the assessment and later evaluation. It does not explain why caregivers act, which is the job of the chosen theory.

Conclusion

Social Cognitive Theory fits a problem of capability, confidence and access in a population that already understands the danger. The next units will map each activity to a named construct and measure those constructs directly.

References

Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191-215. https://doi.org/10.1037/0033-295X.84.2.191

Bandura, A. (2004). Health promotion by social cognitive means. Health Education & Behavior, 31(2), 143-164. https://doi.org/10.1177/1090198104263660

Green, L. W., & Kreuter, M. W. (2005). Health program planning: An educational and ecological approach (4th ed.). McGraw-Hill.

Rosenstock, I. M. (1974). Historical origins of the health belief model. Health Education Monographs, 2(4), 328-335. https://doi.org/10.1177/109019817400200403

Sicherer, S. H., Forman, J. A., & Noone, S. A. (2000). Use assessment of self-administered epinephrine among food-allergic children and pediatricians. Pediatrics, 105(2), 359-362. https://doi.org/10.1542/peds.105.2.359