Socio‐economic status and theories of health behaviour: Time to upgrade a control variable

Schüz, Benjamin

doi:10.1111/bjhp.12205

Cited by 94 publications

(42 citation statements)

References 36 publications

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“…() only found a significant moderation of the association between health cognitions and behaviour when area‐level SES measures were used but not individual‐level measures. This suggests that SES may have different effects depending on how it is defined and measured (Schüz, ). Furthermore, the current study did not examine the role of subjective SES, which has been implicated in health inequalities more strongly than objective measures of SES (Adler, Epel, Castellazzo, & Ickovics, ).…”

Section: Discussionmentioning

confidence: 99%

“…Research using social cognition models such as TPB in the health behaviour context have often overlooked the role of SES—either ignoring SES altogether or treating SES as a control variable (Schüz, ). This practice is grounded in the structure of many social cognition theories that assume the influence of distal, less malleable factors such as socioeconomic influences on behaviour to be mediated by the variables in the theories (Conner & Norman, ).…”

Section: Introductionmentioning

confidence: 99%

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Socioeconomic Status and the Prediction of Health Promoting Dietary Behaviours: A Systematic Review and Meta‐Analysis Based on the Theory of Planned Behaviour

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Schüz

2019

Applied Psych Health & Well

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Background: Dietary behaviours are strongly patterned by socioeconomic status (SES). However, the role of SES in the self-regulation of health promoting dietary behaviours is not fully understood. This systematic review with meta-analysis investigated whether four individual-level measures of SES (income, occupation, education, and ethnicity) moderate the relationships between Theory of Planned Behaviour (TPB) variables and different health promoting dietary behaviours in adults. Methods: A systematic literature search identified 106 studies from 77 articles providing information on TPB variables, SES, and health promoting dietary behaviours-choosing health promoting foods and restricting health compromising foods. Random-effects meta-analyses were conducted to generate pooled correlations corrected for sampling and measurement error, and meta-regression was used to test moderating effects of study-level SES. Results: All TPB variables were significantly and positively associated with both health promoting dietary behaviours, with intention having the strongest correlation with behaviour. However, none of the relationships between TPB variables and health promoting dietary behaviours were significantly moderated by study-level SES. Conclusions: Results suggest robust associations between TPB predictors and healthy dietary behaviour that are not patterned by individual-level SES measures.Education. There appears to be a relationship between educational attainment and diet quality, with those with higher educational attainment adhering to SES AND DIETARY BEHAVIOURS IN THE TPB 383

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Socioeconomic Status and the Prediction of Health Promoting Dietary Behaviours: A Systematic Review and Meta‐Analysis Based on the Theory of Planned Behaviour

Figg

Schüz

2019

Applied Psych Health & Well

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“…2018; Schuz, 2017). Therefore, health psychology still needs a 'stronger consideration of SES' (Schuz, 2017,p.5).…”

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confidence: 99%

Classism and dehumanization in chronic pain: A qualitative study of nurses’ inferences about women of different socio‐economic status

Diniz

Castro

Bousfield

et al. 2019

British J Health Psychol

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Objectives. Class-based dehumanization in health is poorly investigated. Beliefs about social class are often shared across cultures, with people of lower socio-economic status (SES) being typically dehumanized. This study specifically examined how nurses' perceptions of pain patients' SES were associated with (more or less) dehumanizing inferences about their pain and different treatment recommendations.Design. Sequential mixed methods including Similitude Analysis (statistical analysis of qualitative data) and a Thematic Analysis. Fifty female nurses watched short videos of two white women of different SES (low vs. middle) and similar levels of pain behaviours. Afterwards, nurses were asked to complete (1) a Free Association Task (associating characteristics and a profession to the women) and (2) a Story-Completion Task (writing a story describing women's lives, pain, and recommending treatments). Data were analysed with Similitude and Thematic Analysis.Results. The women's SES was recognized, linked to distinct professions, and associated with distinct inferences. The middle-SES woman was depicted with both Uniquely Human (e.g., autonomous) and Human Nature (e.g., communicative) traits, positive future prospects, and competence to self-manage pain. The low-SES woman was associated with Human Nature traits (hard-working) but denied Uniquely Human traits associated with competence; she was imagined as passive towards pain, with poor future prospects and referred to psychoeducation.Conclusion. Findings reveal the role of class-based cultural belief systems in pain care, showing how nurses' recognition of low SES is associated with dehumanizing inferences and recommendations, which may contribute to reproducing pain care disparities. Theoretical implications of these findings for social and health psychology are drawn.

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“…Health behaviour research that includes inequality as a predictor, mediator or moderator is based on a multitude of theories and is often conducted as a by-product of examining different research questions, as the influence of inequality on health behaviours is poorly specified in most theories of health behaviour (Schüz, 2017). This implies that an integrative theoretical framework is needed that allows categorising the constructs of multiple theories into theoretical domains for further investigation of inequality effects.…”

Section: Determinants Of Health Behaviours and Social Inequalitymentioning

confidence: 99%

“…However, neither the TDF nor most theories of health behaviour specify how social inequality might affect engagement in health behaviours. Some theories like the Health Belief Model (Rosenstock, 1974) and the Social-Cognitive Theory (Bandura, 1986) feature social inequality indicators as parts of the environment that provides opportunities or impediments to action, but influences of social inequality on health behaviour aren't explicitly conceptualized in health behaviour theories yet (Schüz 2017).…”

Section: Determinants Of Health Behaviours and Social Inequalitymentioning

confidence: 99%

Social inequality, health behaviour determinants and health behaviour: A Systematic Review

Hilz¹,

Conner²,

Schüz³

2019

Preprint

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Objective: Health inequalities are partly due to inequalities in health behaviours. However, little is known about psychosocial mechanisms underlying health behaviour inequalities. Health behaviour determinants, e.g., those outlined in the Theoretical Domains Framework (TDF) may help understanding health behaviour inequalities. Previously two effect pathways have been theorized: behavioural determinants as mediators of the relationship between inequalities and health behaviour and inequalities as moderators of the relationship between behavioural determinants and health behaviour. This systematic review will summarise the existing literature on both pathways.Design: Relevant databases will be searched systematically for observational quantitative studies examining the indirect or moderating effects of inequality in the relationship between health behaviour determinants and health behaviour. Health behaviour determinants will be categorized according to the TDF, inequality indicators will be operationalized according to the PROGRESS-Plus framework. We will extract estimates of indirect effects and estimates of interaction effects. Quantitative meta-analysis will be conducted if study numbers allow.Discussion: This systematic review will summarise the current of evidence on indirect or moderating effects of social inequality in the relationship between determinants of health behaviour and health behaviour. The results of this review have substantial relevance for theory development, theory refinement and development of equity-focused interventions.Keywords: Social Inequality, Health Behaviour, Determinants of Health Behaviour, Theoretical Domains Framework, Mediation, Moderation

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Socio‐economic status and theories of health behaviour: Time to upgrade a control variable

Cited by 94 publications

References 36 publications

Socioeconomic Status and the Prediction of Health Promoting Dietary Behaviours: A Systematic Review and Meta‐Analysis Based on the Theory of Planned Behaviour

Socioeconomic Status and the Prediction of Health Promoting Dietary Behaviours: A Systematic Review and Meta‐Analysis Based on the Theory of Planned Behaviour

Classism and dehumanization in chronic pain: A qualitative study of nurses’ inferences about women of different socio‐economic status

Social inequality, health behaviour determinants and health behaviour: A Systematic Review

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