Despite the popularity and widespread use of theory in health education, practitioners still find it difficult to design and implement theory-based interventions. This is especially true when working with ethnic/racial minority groups, including Hispanic groups. Practitioners working with Hispanic communities face additional barriers that may often discourage them from using theories when planning interventions. These barriers include the diversity that exists within the Hispanic population, lack of reliable data, and issues related to cross-cultural applicability of current behavior theories. However, the use of theory constitutes a valuable tool for developing more effective programs, and theorist researchers should be more sensitive to practitioners’ needs. By explaining the processes for selecting and applying theory in the same detail as outcome results, researchers will contribute to increasing practitioners’ interest in theory. This article describes Camine con Nosotros, a theory-based physical activity program for Hispanic women, and explains the process of selecting the theoretical framework of the program and connecting theory and practice.
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References
1.
Ali, N. S., & Twibell, R. K. (1995). Health promotion and osteoporosis prevention among postmenopausal women. Preventive Medicine, 24, 528-534.
2.
Baker, E. A., Boulding, N., Durham, M., Escobar Lowell, M., González, M., Jodaitis, N., Negrón Cruz, L., Torres, I., Torres, M., & Trillio Adams, S. (1997). The Latino health advocacy program: A collaborative lay health advisor approach. Health Education and Behavior, 24, 495-509.
3.
Bandura, A. (1977). Social Learning Theory. Englewood Cliffs, NJ: Prentice Hall.
4.
Bandura, A. (1986). Social foundations of thought and action: A social-cognitive theory. Englewood Cliffs, NJ: Prentice Hall.
5.
Bartholomew, L. K., Parcel, G. S., & Kok, G. (1998). Intervention mapping: A process for developing theory- and evidence-based health education programs. Health Education and Behavior, 25, 545-563.
6.
Burchfield, C. M., Hamman, R. F., Marshall, J. A., Baxter, J., Kahn, L. B., & Amirani, J. J. (1990). Cardiovascular risk factors and impaired glucose tolerance: The San Luis Valley Diabetes Study. American Journal of Epidemiology, 131, 57-70.
7.
Campbell, P. (1994). Population projections of the United States, by age, race, and sex: 1993 to 2020 (Current Population Reports Series P25-1111). Washington, DC: Bureau of the Census.
8.
Cantor, J. C., Bergeisen, L., & Baker, L. C. (1998). Effect of an intensive educational program for minority college students and recent graduates on the probability of acceptance to medical school. Journal of the American Medical Association, 280, 772-776.
9.
Caspersen, C. J., Christenson, G. M., & Pollard, R. A. (1986). Status of the 1990 physical fitness and exercise objectives—evidence from NHIS 1985. Public Health Reports, 101, 587-592.
10.
Centers for Disease Control and Prevention. (1991a). National Health Interview Survey, 1991 [Public use data tapes]. Atlanta, GA: National Center for Health Statistics, Centers for Disease Control and Prevention.
11.
Centers for Disease Control and Prevention. (1991b). National Health and Nutrition Examination Survey (NHNES III) (1988–1991) [Public use data tapes]. Atlanta, GA: National Center for Health Statistics, Centers for Disease Control and Prevention.
12.
Centers for Disease Control and Prevention. (1992). 1992 BRFSS summary prevalence report. Atlanta, GA: Department of Health and Human Services, Public Health Service, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention.
13.
Centers for Disease Control and Prevention. (1994). Chronic disease in minority populations. Atlanta, GA: Author.
14.
Crespo, C. J., Keteyian, S. J., Heath, G. W., & Sempos, C. T. (1996). Leisure-time physical activity among U.S. adults: Results from the Third National Health and Nutrition Examination Survey. Archives of Internal Medicine, 156, 93-98.
15.
Dishman, R. K., & Gettman, L. R. (1980). Psychobiologic influences on exercise adherence. Journal of Sport and Exercise Psychology, 2, 295-310.
16.
Dishman, R. K., & Sallis, J. F. (1994). Determinants and interventions for physical activity and exercise. In C. Bouchard, R. J. Shephard, & T. Stephens (Eds.), Physical activity, fitness, and health: International proceeding and consensus statement. Champaign, IL: Human Kinetics.
17.
Dishman, R. K., & Steinhardt, M. (1990). Health locus of control predicts free-living, but not supervised, physical activity: A test of exercise-specific control and outcome-expectancy hypotheses. Research Quarterly for Exercise and Sport, 61, 383-394.
18.
D’Onofrio, C. N. (1992). Theory and the empowerment of health education practitioners. Health Education Quarterly, 19, 385-403.
19.
Eng, E. (1993). The Save our Sisters Project: A social network strategy for reaching rural Black women. Cancer, 72, 1071-1077.
20.
Eng, E., & Young, R. (1992). Lay health advisors and community change agents. Family and Community Health, 15, 24-40.
21.
Felton, G. M., & Parson, M. A. (1994). Factors influencing physical activity in average-weight and overweight young women. Journal of Community Health Nursing, 11, 109-119.
22.
Finnegan, J. R., Viswanath, K., Kahn, E., & Hannan, P. (1993). Exposure to sources of heart disease prevention information: Community type and social group differences. Journalism Quarterly, 70, 569-584.
23.
Ford, E. S., & Jones, D. H. (1991). Cardiovascular health knowledge in the United States: Findings from the National Health Interview Survey, 1985. Preventive Medicine, 20, 725-736.
24.
Glanz, K., Lewis, F. M., & Rimer, B. (Eds.). (1997). Health behavior and health education: Theory, research, and practice. San Francisco, CA: Jossey-Bass.
25.
Good, B. J., & Good, M. J. (1986). The cultural context of diagnosis and therapy: A view from medical anthropology. In M. R. Miranda & H. Kitano (Eds.), Mental health research and practice in minority communities: Development of culturally sensitive training programs (pp. 1-27). Washington, DC: National Institute of Mental Health.
26.
Green, L. W. (1991). Everyone has a theory, few have measurement. Health Education Research, 6, 249-250.
27.
Hazuda, J. P., Stern, M. P., Gaskill, S. P., Haffner, S. M., & Gardner, L. I. (1983). Ethnic differences in health knowledge and behaviors related to the prevention and treatment of coronary heart disease: The San Antonio Heart Study. American Journal of Epidemiology, 117, 717-728.
28.
Houchbaum, G. M. (1958). Public participation in medical screening programs: A sociopsychological study (USPHS Publication No. 572). Washington, DC: Public Health Service.
29.
Hovell, M., Sallis, J., Hofstetter, R., Barrington, E., Hackley, M., Elder, J., Castro, F., & Kilbourne, K. (1991). Identification of correlates of physical activity among Latino adults. Journal of Community Health, 16, 23-36.
30.
Israel, B. (1985). Social network and social support: Implications for natural helper and community level interventions. Health Education Quarterly, 12, 65-80.
31.
Jackson, M. Y., Proulx, J. M., & Pelican, S. (1991). Obesity prevention. American Journal of Clinical Nutrition, 53, 1625S-1630S.
32.
Jacobson, H. (1999). La comunicación con pacientes hispanohablantes [Communicating with Spanish-speaking patients]. Médico Interamericano, 18, 12-16. Available: http://www.users.interport.net/%7Eicps/medico/medico99/january/
33.
Kimiecik, J. (1992). Predicting vigorous physical activity of corporate employees: Comparing the theories of reasoned action and planned behavior. Journal of Sport and Exercise Psychology, 14, 192-206.
34.
King, A. C., Blair, S. N., Bild, D. E., Dishman, R. K., Dubbert, P. M., Marcus, B. H., Oldridge, N. B., Paffenbarger, R. S., Powell, K. E., & Yeager, K.. (1997). Determinants of physical activity and interventions in adults. Medicine and Science in Sports and Exercise, 24, S221-S236.
35.
King, A. C., Haskell, W. L., Young, D. R., Oka, R. K., & Stefanick, M. L. (1995). Long-term effects of varying intensities and formats of physical activity on participation rates, fitness, and lipoproteins in men and women aged 50 to 65 years. Circulation, 91, 2596-2604.
36.
Marín, G., & VanOss Marín, B. (1991). Research with Hispanic populations. Newbury Park, CA: Sage.
37.
Meister, J., Warrick, L. L., Zapién, J., & Wood, A. (1992). Using lay health workers: Case study of a community-based prenatal intervention. Journal of Community Health, 17, 37-51.
38.
Minor, M. A., & Brown, J. D. (1993). Exercise maintenance of persons with arthritis after participation in a class experience. Health Education Quarterly, 20, 83-95.
39.
Mirotznik, J., Feldman, L., & Stein, R. (1995). The Health Belief Model and adherence with a community center-based, supervised coronary heart disease exercise program. Journal of Community Health, 20, 233-247.
40.
National Center for Health Statistics. (1997). Healthy people 2000 review, 1997 (DHHS Publication No. PHS 98-1256). Hyattsville, MD: Department of Health and Human Services.
41.
National Coalition of Hispanic Health and Human Services Organizations (COSSMHO). (1995). Meeting the health promotion needs of Hispanic communities. American Journal of Health Promotion, 9, 300-311.
42.
Neuberger, G. B., Kasal, S., Smith, K. V., Hassanein, R., & DeViney, S. (1994). Determinants of exercise and aerobic fitness in outpatients with arthritis. Nursing Research, 43, 11-17.
43.
Oldridge, N. B., & Streiner, D. L. (1990). The Health Belief Model: Predicting compliance and dropout in cardiac rehabilitation. Medicine and Science in Sports and Exercise, 22, 678-683.
44.
Palepu, A., Carr, P. L., Friedman, R. H., Amos, H., Ash, A. S., & Moskowitz, M. A. (1998). Minority faculty and academic rank in medicine. Journal of the American Medical Association, 280, 767-771.
45.
Pasick, R. J. (1997). Socioeconomic and cultural factors in the development and use of theory. In K. Glanz, F. M. Lewis, & B. K. Rimer (Eds.), Health behavior and health education: Theory, research, and practice (pp. 425-440). San Francisco, CA: Jossey-Bass.
46.
Pasick, R. J., D'Onofrio, C. N., & Otero-Sabogal, R. (1996). Similarities and differences across cultures: Questions to inform a third generation for health promotion research. Health Education Quarterly, 23, S142-S161.
47.
Perez-Stable, E. J., Marín, G., & Marín, B. V. (1994). Behavioral risk factors: A comparison of Latinos and non-Latino whites in San Francisco. American Journal of Public Health, 84, 971-976.
48.
Perez-Stable, E. J., Sabogal, F., Otero-Sabogal, R., Hiatt, R. A., & McPhee, S. J. (1992). Misconceptions about cancer among Latinos and Anglos. Journal of the American Medical Association, 268, 3219-3223.
49.
Pollock, M. L. (1998). Prescribing exercise for fitness and adherence. In R. K. Dishman (Ed.), Exercise adherence (pp. 259-277). Champaign, IL: Human Kinetics.
50.
Prevalence of selected risk factors for chronic disease by education level in racial/ethnic populations—United States, 1991-1992. (1994). Morbidity and Mortality Weekly Report, 43, 894-899.
51.
Rogler, L. H., Malgady, R. G., & Rodríguez, O. (1989). Hispanics and mental health: A framework for research. Malabar, IL: Robert E. Krieger.
52.
Sallis, J. F., Haskell, W. L., Fortmann, S. P., Vranizan, K. M., Taylor, C. B., & Solomon, D. S. (1986). Predictors of adoption and maintenance of physical activity in a community sample. Preventive Medicine, 15, 331-341.
53.
Sallis, J. F., Hovell, M. F., & Hofstetter, C. R. (1992). Explanation of vigorous activity during two years using social learning variables. Social Science and Medicine, 34, 25-32.
54.
Sallis, J. F., Hovell, M. F., Hofstetter, C. R., Faucher, P., Elder, J. P., Blanchard, J., Carpensen, C. J., Powell, K. E., & Christenson, G. M. (1989).A multivariate study of determinants of vigorous exercise in a community sample. Preventive Medicine, 18, 20-34.
55.
Sallis, J. F., Pinski, R. B., Grossman, R. M., Patterson, T. L., & Nader, P. R. (1988). The development of self-efficacy scales for health-related diet and exercise behaviors. Health Education Research, 3, 283-292.
56.
Soto Mas, F. (1999). Salud para todos en el año 2000: Una agenda de salud pública hispana para el siglo XXI [Health for all by the year 2000: A Hispanic public health agenda for the 21st century]. Médico Interamericano, 18, 6-10. Available: http://www.users.interport.net/%7Eicps/medico/medico99/january/
57.
Soto Mas, F., & Papenfuss, R. (1997). El médico hispano y la promoción de la salud [The role of the Hispanic physician in health promotion]. Médico Interamericano, 16, 206-209.
58.
Soto Mas, F., Papenfuss, R. L., & Guerrero, J. J. (1997). Hispanics and worksite health promotion: Review of the past, demands for the future. Journal of Community Health, 22, 361-371.
59.
Tichenor, P. J., Donohue, G. A., & Olien, C. N. (1970). Mass media flow and differential growth in knowledge. Public Opinion Quarterly, 34, 159-170.
60.
Turner, B. S. (1987). Medical power and social knowledge. Newbury Park, CA: Sage.
61.
U.S. Bureau of the Census. (1993). Income, poverty and health insurance, 1992. Washington, DC: Author.
62.
U.S. Department of Health and Human Services. (1996). Physical activity and health: A report of the surgeon general. Atlanta, GA: Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion.
63.
van Ryn, M., & Heaney, C. A. (1992). What’s the use of theory?Health Education Quarterly, 19, 315-330.
64.
Weber, J., & Wertheim, E. H. (1989). Relationships of self-monitoring, special attention, body fat percent, and self-motivation to attendance at a community gymnasium. Journal of Sport and Exercise Psychology, 11, 105-114.
