Little research has explored the relationship between social influences (e.g., social networks, social support, social norms) and health as related to modifying factors that may contribute to health disparities. This is a cross-sectional analysis of fruit and vegetable intake and physical activity, using baseline data from two cancer prevention studies with working-class, multi-ethnic adults. Several social influence and social contextual variables were associated with fruit and vegetable intake and physical activity in both samples. Fruit and vegetable consumption was associated with social norms and social networks, although different contextual variables also were related to intake across the two samples. Physical activity was associated with social networks, social norms, and competing demands. By examining how key social influence and contextual mediating variables relate to health behaviors, we can learn more about the types of interventions that might be needed to promote sustained health behavior change in this population.
Airhihenbuwa, C. , Kumanyika, S. , TenHave, T. , & Morssink, C. (2000). Cultural identity and health lifestyles among African Americans: A new direction for health intervention research?Ethnicity and Disease, 10(2), 148-164 .
2.
Anderson, N. , & Armstead, C. (1995). Toward understanding the association of socioeconomic status and health: A new challenge for the biopsychosocial approach . Psychosomatic Medicine, 57(3), 213-225 .
3.
Baranowski, T. , Cullen, K.W. , & Baranowski, J. (1999). Psychosocial correlates of dietary intake: Advancing dietary Intervention. In D. B. McCormick (Ed.), Annual review of nutrition (Vol. 19, pp. 17-40). Palo Alto, CA: Annual Reviews .
4.
Barrera, M. , Sandler, I.N. , & Ramsey, T.B. (1981). Preliminary development of a scale of social support: Studies on college students . American Journal of Community Psychology, 58(3), 304-309 .
5.
Berkman, L.F. , & Glass, T. (2000). Social integration, social networks, social support, and health. In L. F. Berkman & I. Kawachi (Eds.), Social epidemiology (pp. 137-173). New York: Oxford University Press .
6.
Berrigan, D. , Dodd, K. , Troiano, R.P. , Krebs-Smith, S.M. , & Barbash, R.B. (2003). Patterns of health behavior in U.S. adults . Preventive Medicine, 36(5), 615-623 .
7.
Bettenhausen, K. , & Murnighan, J.K. (1985). The emergence of norms in competitive decision-making groups . Administrative Science Quarterly,30, 350-372 .
8.
Booth, S.L. , Sallis, J.F. , Ritenbaugh, C. , Hill, J.O. , Birch, L.L. , Frank, L.D. , et al. (2001). Environmental and societal factors affect food choice and physical activity: Rationale, influences and leverage points . Nutrition Reviews, 59(3), S21-S39 .
9.
Carlson, L. , Goodey, E. , Bennett, M. , Taenzer, P. , & Koopmans, J. (2002). The addition of social support to a community-based large-group behavioral smoking cessation intervention: Improved cessation rates and gender differences . Addictive Behaviors, 27(4), 547-559 .
10.
Chavez, V. , Duran, B. , Baker, Q. , Avila, M. , & Wallerstein, N. (2003). The dance of race and privilege in community based participatory research. In M. Minkler & N. Wallerstein (Eds.), Community based participatory research for health (pp. 81-87). San Francisco: John Wiley .
11.
Coday, M. , Klesges, L. , Garrison, R. , Johnson, K. , O'Toole, M. , & Morris, G. (2002). Health opportunities with physical exercise (HOPE): Social contextual interventions to reduce sedentary behavior in urban settings . Health Education Research, 17(5), 637-647 .
12.
Cohen, D.A. , Scribner, R.A. , & Farley, T.A. (2000). A structural model of health behavior: A pragmatic approach to explain and influence health behaviors at the population level . Preventive Medecine, 30, 146-154 .
13.
Delgado, J. , Metzger, R. , & Falcon, A. (1995). Meeting the health promotion needs of Hispanic communities . American Journal of Health Promotion, 9, 300-311 .
14.
Devine, C.M. , Connors, M.M. , Sobal, J. , & Bisogni, C.A. (2003). Sandwiching it in: Spillover of work onto food choices and family roles in low- and moderate-income urban households . Social Science & Medicine, 56(3), 617-630 .
15.
Devine, C.M. , & Olson, C.M. (1992). Women's perception about the way social roles promote or constrain personal nutrition care . Women Health , 19(1), 79-95 .
16.
Emmons, K. , Stoddard, A. , Gutheil, C. , Gonzalez Roberts, E. , & Lobb, R. (in press). Cancer prevention for working class, multi-ethnic populations through health centers: The Healthy Directions Study . Cancer Causes and Control.
17.
Eyler, A.A. , Brownson, R.C. , Donatelle, R.J. , King, A.C. , Brown, D. , & Sallis, J.F. (1999). Physical activity social support and middle- and older-aged minority women: Results from a US survey . Social Science & Medicine, 49(6), 781-789 .
18.
Fagan, P. , Eisenberg, M. , Stoddard, A.M. , Frazier, L. , & Sorensen, G. (2001). Social influences, social norms, social support, and smoking behavior among adolescent workers . American Journal of Health Promotion, 15(6), 414-421 .
19.
Fraser, S.N. , & Spink, K.S. (2002). Examining the role of social support and group cohesion in exercise compliance. Journal of BehavioralMedicine , 25(3), 233-249 .
20.
Glanz, K. , & Mullis, R.M. (1988). Environmental intervention to promote healthy eating: A review of models, programs, and evidence . Health Education Quarterly, 15(4), 395-415 .
21.
Graham, H. (1994). When life's a drag: Women, smoking and disadvantage . London: University of Warwick , Department of Health .
22.
Graham, H. (1998). Health at risk: Poverty and national health strategies . In L. Doyal (Ed.), Women and health services: An agenda for change. Philadelphia : Open University Press . Heaney, C. , & Israel, B.A. (2002). Social networks and social support. In K. Glanz , B. Rimer , & F. Lewis (Eds.), Health behavior and health education: Theory, research, and practice (3rd ed., pp. 185-209). San Francisco: Jossey-Bass .
23.
Hunt, M.K. , Stoddard, A.M. , Barbeau, E. , Goldman, R. , Goldman, R. , Wallace, L. , et al. (in press). Cancer prevention for working class, multiethnic populations through small businesses: The Healthy Directions Study . Cancer Causes and Control.
24.
Institute of Medicine and Committee on Communication for Behavior Change in the 21st Century. (2002). Improving the health of diverse populations, speaking of health: Assessing health communication strategies for diverse populations. Washington, DC: National Academies Press .
25.
Karasek, R. , & Theorell, T. (1990). Healthy work: Stress, productivity, and the reconstruction of working life. New York: Basic Books .
26.
Kiecolt-Glaser, J.K. , & Newton, T.L. (2001). Marriage and health: His and hers . Psychological Bulletin, 127(4), 472-503 .
27.
King, A.C. , Castro, C. , Wilcox, S. , Eyler, A.A. , Sallis, J.F. , & Brownson, R.C. (2000). Personal and evnironmental factors associated with physical inactivity among different racial-ethnic groups of U.S. middle-aged and older-aged women . Health Psychology , 19(4), 354-364 . Krieger, N. , Chen, J.T. , Waterman, P.D. , Soobader, M.J. , Subramanian, S.V. , & Carson, R. (2002). Geocoding and monitoring of US socioeconomic inequalities in mortality and cancer incidence: Does the choice of area-based measure and geographic level matter?American Journal of Epidemiology , 156(5), 471-482 .
28.
Krieger, N. , Williams, D.R. , & Moss, N.E. (1997). Measuring social class in US public health research: Concepts, methodologies, and guidelines. Annual Review of PublicHealth, 18, 341-378 .
29.
Lantz, P.M. , House, J.S. , Lepkowski, J.M. , Williams, D.R. , Mero, R.P. , & Chen, J. (1998). Socioeconomic factors, health behaviors, and mortality: Results from a nationally representative prospective study of US adults. Journal of theAmerican Medical Association, 279(21), 1703-1708 .
30.
Leviton, L.C. , Snell, E. , & McGinnis, M. (2000). Urban issues in health promotion strategies . American Journal of Public Health, 90(6), 863-866 .
31.
Linnan, L. , Sorensen, G. , Colditz, G. , Klar, N. , & Emmons, K. (2001). Using theory to understand the multiple determinants of low participants in worksite health promotion programs . Health Education and Behavior, 28(5), 591-607 .
32.
Littell, R. , Milliken, G. , George, A. , Stroup, W. , & Wolfinger, R. (1996). SAS systems for mixed models. Cary, NC: SAS Institute Inc.
33.
Murray, D. (1998). Design and analysis of group randomized trials . New York: Oxford University Press .
34.
National Cancer Institute. (In press). Nation's investment in research: A budget proposal for Fiscal Year 2004. Washington, DC: Author .
35.
Popkin, B.M. , Siega-Riz, A.M. , & Haines, P.S. (1996). A comparison of dietary rends among racial and socioeconomic groups in the United States . New England Journal of Medicine, 335(10), 716-720 .
36.
Raven, B.H. , & Rubin, J. (1996). People in groups. New York : Wiley Press .
37.
Resnick, B. , Orwig, D. , Magaziner, J. , & Wynne, C. (2002). The effect of social support on exercise behavior in older adults . Clinical Nursing Research, 11 (1), 52-70 .
38.
Sallis, J.F. , & Owen, N. (1997). Ecological models. In K. Glanz , F. M. Lewis , & B. K. Rimer (Eds.), Health behavior and health education: Theory, research, and practice (2nd ed., pp. 403-424). San Francisco: Jossey-Bass .
39.
Sallis, J.F. , & Owen, N. (1999). Physical activity and behavioral medicine. Thousand Oaks, CA: Sage .
40.
Serdula, M.K. , Gillespie, C. , Kettel-Khan, L. , Farris, R. , Seymour, J. , & Denny, C. (2004). Trends in fruit and vegetable consumption among adults in the United States: Behavioral Risk Factor Surveillance System, 1994-2000 . American Journal of Pubic Health, 94(6), 1014-1018 .
41.
Sorensen, G. , Emmons, K.M. , Hunt, M.K. , Barbeau, E. , Goldman, R. , Peterson, K. , et al. (2003). Model for incorporating the social context in health behavior interventions: Applications for cancer prevention for working-class, multiethnic populations . Preventive Medicine, 37, 188-197 .
42.
Sorensen, G. , Emmons, K. , Hunt, M.K. , & Johnston, D. (1998). Implications of the results of community intervention trials. Annual Review of PublicHealth, 19, 379-416 .
43.
Sorensen, G. , Emmons, K. , Stoddard, A. , & Linnan, L. (2002). Do social influences contribute to occupational differences in smoking behavior?American Journal of Health Promotion, 16(3), 135-141 .
44.
Sorensen, G. , Stoddard, A. , LaMontagne, A. , Emmons, K. , Hunt, K. , Youngstrom, R. , et al. (2002). A comprehensive worksite cancer prevention intervention: Behavior change results from a randomized controlled trial . Cancer Causes and Control, 13(6), 493-503 .
45.
Sorensen, G. , Stoddard, A. , Peterson, K. , Cohen, N. , Hunt, M. , Stein, E. , et al. (1999). Increasing fruit and vegetable consumption through worksites and families in the Treatwell 5-a-Day Study . American Journal of Public Health, 89(1), 54-60 .
46.
Stoller, E. , & Gibson, R. (1999). Worlds of difference: Inequality in the aging experience. Thousand Oaks, CA: Forge Press .
47.
Suarez, L. , Ramirez, A.G. , Villarreal, R. , Marti, J. , McAlister, A. , Talavera, G.A. , et al. (2000). Social networks and cancer screening in four U.S. Hispanic groups . American Journal of Preventive Medicine, 19(1), 47-52 .
48.
Subar, A.S. , Heimdinger, J. , Krebs-Smith, S.M. , Patterson, B.H. , Kessler, R. , & Pivonka, E. (1995). Fruit and vegetable intake in the United States: The baseline survey of the Five a Day for Better Health Program . American Journal of Health Promotion, 9(5), 352-360 . Thompson, F.E. , Midthune, D. , Subar, A.F. , McNeel, T. , Berrigan, D. , & Kipnis, V. (2005). Dietary intake estimates in the National Health Interview Survey, 2000: Methodology, results, and interpretation . Journal of the American Dietetic Association, 105(3), 352-363 . Umberson, D. (1992). Gender, marital status and the social control of health behavior . Social Science & Medicine, 34(8), 907-917 .
49.
U.S. Department of Agriculture, & U.S. Department of Health and Human Services. (2000). Nutrition and your health: Dietary guidelines for Americans (5th ed.). Washington, DC: Government Printing Office .
50.
U.S. Department of Health and Human Services. ( 1996). Physical activity and health: A report of the surgeon general. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion .
51.
U.S. Department of Health and Human Services. ( 2000). Healthy People 2010: Understanding and improving health and objectives for improving health (2nd ed.). Washington, DC: Government Printing Office .
52.
U.S. Department of Health and Human Services. ( 2001). The 2001 HHS poverty guidelines. Retrieved from http://aspe.hhs.gov/poverty/01poverty.htm
53.
Wolf, A.M. , Hunter, D.J. , Colditz, G.A. , Manson, J.E. , Stampfer, M.J. , Corsano, K.A. , et al. (1994). Reproducibility and validity of a self-administered physical activity questionnaire. InternationalEpidemiology , 23, 991-999 .
54.
Wolfinger, R. , & O'Connell, M. (1993). Generalized linear models: A pseudo-likelihood approach. Journal of Statistical Computation andSimulation , 48, 233-243 .
