How do health behaviour interventions take account of social context? A literature trend and co-citation analysis

Abstract

In recent years, health behaviour interventions have received a great deal of attention in both research and policy as a means of encouraging people to lead healthier lives. The emphasis of such interventions has varied over time, in terms of level of intervention (e.g. individual vs community) and drawing on different disciplinary perspectives. Recently, a number of critiques have focused on how health behaviour interventions sometimes sideline issues of social context, framing health as a matter of individual choice and, by implication, a personal responsibility. Part of this criticism is that health behaviour interventions often do not draw on alternative social science understandings of the structured and contextual aspects of behaviour and health. Yet to our knowledge, no study has attempted to empirically assess the extent to which, and in what ways, the health behaviour intervention field has paid attention to social context. In this article, we undertake this task using bibliometric techniques in order to map out the health behaviour intervention field. We find that the number of health behaviour interventions has grown rapidly in recent years, especially since around 2006, and that references to social science disciplines and concepts that foreground issues of social context are rare and, relatively speaking, constitute less of the field post 2006. More quantifiable Corresponding author:Daniel Holman, Department of Sociological Studies, University of Sheffield, Elmfield, Northumberland Road, Sheffield S10 2TU, UK. Email: daniel.holman@sheffield.ac.uk 695630H EA0010.1177/1363459317695630HealthHolman et al. research-article2017Article 390 Health 22 (4) concepts are used most, and those more close to the complexities of social context are mentioned least. The document co-citation analysis suggests that pre 2006, documents referring to social context were relatively diffuse in the network of key citations, but post 2006 this influence had largely diminished. The journal co-citation analysis shows less disciplinary overlap post 2006. At present, health behaviour interventions are continuing to focus on individualised approaches drawn from behavioural psychology and behavioural economics. Our findings lend empirical support to a number of recent papers that suggest more interdisciplinary collaboration is needed to advance the field.

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“…20 Another study published in 2017 found that references to social context had become less frequent in health behaviour change intervention research since 2006 and called on research funders and other stakeholders to develop guidance on how to take account of social and cultural contexts. 18,21 There is a need both to identify existing good practice and to move the field forward by extending existing perspectives and inviting new approaches that address the significance of context for population health interventions. This document seeks to pull together recent thinking and practical experience of addressing context within PHIR.…”

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“…Critical histories of health psychology (Crawford, 2006;Murray, 2014) have argued that health psychologists need to take a role in addressing those social injustices that produce ill-health. Despite this, behaviour change interventions targeting social context have become rarer in the last decade (Holman, Lynch, & Reeves, 2017).…”