title: Model for incorporating social context in health behavior interventions: applications for cancer prevention for working-class, multiethnic populations.
abstract: BACKGROUND
  This article proposes a conceptual framework for addressing social contextual factors in cancer prevention interventions, and describes work that operationalizes this model in interventions for working class, multiethnic populations.
  
  
  METHODS
  The Harvard Cancer Prevention Program Project Includes Three Studies: (1) an intervention study in 25 small businesses; (2) an intervention study in 10 health centers; and (3) a computer simulation modeling project that translates risk factor modifications into gains in life expectancy and number of cancers averted. The conceptual framework guiding this work articulates pathways by which social context may influence health behaviors, and is used to frame the interventions and guide evaluation design.
  
  
  RESULTS
  Social contextual factors cut across multiple levels of influence, and include individual factors (e.g., material circumstances, psychosocial factors), interpersonal factors (e.g., social ties, roles/responsibilities, social norms), organizational factors (e.g., work organization, access to health care), and neighborhood/community factors (e.g., safety, access to grocery stores). Social context is shaped by sociodemographic characteristics (e.g., social class, race/ethnicity, gender, age, language) that impact day-to-day realities.
  
  
  CONCLUSIONS
  By illuminating the pathways by which social contextual factors influence health behaviors, it will be possible to enhance the effectiveness of interventions aimed at reducing social inequalities in risk behaviors.
authors.affiliation: Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA 02115, USA. glorian_sorensen@dfci.harvard.edu
authors.forename: Glorian
authors.initials: G
authors.lastname: Sorensen
authors.forename: Karen
authors.initials: K
authors.lastname: Emmons
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Hunt
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barbeau
authors.forename: Roberta
authors.initials: R
authors.lastname: Goldman
authors.forename: Karen
authors.initials: K
authors.lastname: Peterson
authors.forename: Karen
authors.initials: K
authors.lastname: Kuntz
authors.forename: Anne
authors.initials: A
authors.lastname: Stoddard
authors.forename: Lisa
authors.initials: L
authors.lastname: Berkman
mesh_terms: D001521:Behavior Therapy; D015438:Health Behavior / Q000208:ethnology; D006801:Humans; D008962:Models, Theoretical; D009369:Neoplasms / Q000208:ethnology / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D012961:Sociology