1. APPLICATION AT THE ORGANIZATIONAL LEVEL Interorganizational Relations (IOR) Theory Describes how organizations collaborate Three networks Obligational Promotional Systemic CAAA established an informal obligational network To address that some community organizations were not environmentally focused

2. APPLICATION AT THE POLICY LEVEL Agenda-Building Theory Emphasizes matching—identifying where an issue is on the policy-making timeline Three models Outside-initiative Inside-initiative Mobilization As of 2004, CAAA had held two community forums and met with local politicians to raise awareness about asthma- related exposures

3. APPLICATION AT THE COMMUNITY LEVEL Community organization (Review) Three models Locality (community) development Social planning Social action Constructs Empowerment, Community capacity, Participation, Relevance, Issue selection, Critical consciousness Authors cite the use of Locality development and Social action in the intervention

4. ECOLOGICAL STRESS PROCESS MODEL FOR ENVIRONMENTAL HEALTH PROMOTION New model accounts for the fact that environmental health issues are complex and involve different stressors Integrates both Ecological Model Framework and Stress Process Model, in addition to other health behavior theories Stressors are environmental demands which influence “psychological and biological changes that may place persons at risk of disease”

6. ECOLOGICAL STRESS MODEL Five categories of stressors Ambient environment Direct stressor Major life events Disrupt everyday activities Daily hassles Chronic strains Due to sociocultural/socioeconomic factors Cataclysmic events Environmental health experts respond to natural disasters

8. IMPLICATIONS OF THE ECOLOGICAL STRESS MODEL CESs (the outreach workers) worked with families to reduce stressors so that caregivers could focus on changing their behavior This is key: authors do not claim this model to be a one- size fits all Relationship between individual and community is important in environmental health Cultural context is important We saw how effective tailoring can be in Health Communication Social injustice (race, socioeconomic status) Linked to health status Why procedural equity can be helpful Ex. Navajo nation and the failure to clean up uranium mines

9. Are there other constructs that could fit into this model and be applicable in the CAAA intervention? Or, how might the model differ given another environmental health issue?

10. CONCLUSION For any health issue, no one theory or model will be sufficient enough to identify risk and protective factors or create an effective intervention. I’m convinced. Are you? Can you really pick and choose from different theories? Is this valid?

11. 11 DECISIONS/INTENTIONS SOCIAL S ITUATION BIOLOGY/ P ERSONALITY THE THEORY OF TRIADIC INFLUENCE ATTITUDES TOWARD THE BEHAVIOR SOCIAL NORMATIVE BELIEFS Trial Behavior EXPERIENCES: Expectancies -- Social Reinforcements -- Psychological/Physiological SELF-EFFICACY BEHAVIORAL CONTROL Nurture/CulturalBiological/Nature Intrapersonal StreamSocial/Normative StreamCultural/Attitudinal Stream 192021 22 23 Distal Influences Proximal Predictors Levels of Causation Ultimate Causes Social/ Personal Nexus Expectancies & Evaluations Affect and Cognitions Decisions Experiences a b c d e f g h i j k m n o p q r s t u v w x Related Behaviors J K C F I B E H A D G CULTURAL E NVIRONMENT

12. THANK YOU!