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社会与行为科学

Social and Behavioral Sciences

课程介绍 Course Introduction

学分:3 | 先修课:心理学基础 | 学期:第二学期

本课程介绍社会、行为因素与健康的关系及其在公共卫生中的应用。内容涵盖健康行为理论(健康信念模式、计划行为理论、社会认知理论)、社会决定因素与健康不平等、健康传播与健康教育、行为干预设计与评估、社区健康促进、文化与健康、压力与健康行为改变。通过理论学习和干预设计练习,培养学生从社会行为视角理解和解决公共卫生问题的能力。

This course introduces the relationship between social and behavioral factors and health, and their application in public health. Topics include health behavior theories (Health Belief Model, Theory of Planned Behavior, Social Cognitive Theory), social determinants and health inequalities, health communication and health education, behavioral intervention design and evaluation, community health promotion, culture and health, stress and health behavior change.

大作业 Final Project

作业标题:健康行为干预方案设计与评估

选择一个健康行为问题(如吸烟、缺乏运动或慢性病管理),基于行为理论设计干预方案并制定评估计划。撰写干预方案。

Select a health behavior issue (such as smoking, physical inactivity, or chronic disease management), design an intervention plan based on behavioral theory, and develop an evaluation plan. Write an intervention proposal.

实施步骤 Implementation Steps

示例:研究一个社会因素对健康的影响,比如教育水平与心血管疾病发病风险的关系。你需要利用NHANES或CHARLS队列数据,将教育程度分层并匹配人口学特征,用Cox比例风险模型计算不同教育组的HR值,做中介分析检验健康行为的中介效应,最后绘制生存曲线并讨论社会决定因素的作用机制。
步骤 1
社会流行病学问题选择与研究设计
本步骤的核心任务是选择社会流行病学研究问题,设计研究方案。社会流行病学研究社会因素对人群健康的影响,关注健康的社会决定因素(SDH)和健康公平。需要运用社会学和流行病学交叉学科视角,选择具有重要理论和现实意义的研究问题。

• 选择研究主题:从健康的社会决定因素(收入、教育、职业、社会阶层、社会资本、社会支持、居住环境、种族/民族、性别)、健康公平、健康相关行为的社会分布、社区与健康、生命历程视角等方向选择研究问题
• 理论框架构建:选择理论模型(健康的社会决定因素框架、社会生态模型、生命历程理论、社会资本理论、社会梯度理论、根本原因理论),构建研究的概念框架,提出研究假设
• 研究设计:确定研究设计类型(横断面调查、队列研究、病例对照研究、自然实验、多层分析、混合方法研究),确定研究人群和抽样方法,选择社会因素测量工具和健康结局指标
产出:社会流行病学研究设计方案(含研究问题、理论框架、研究设计、测量工具、抽样方案)| 质量标准:研究问题有理论和现实意义,理论框架恰当,设计科学合理
步骤 2
社会因素测量与数据收集
本步骤的核心任务是测量社会因素,收集相关数据。社会因素的测量是社会流行病学研究的难点和关键,需要将抽象的社会概念操作化为可测量的变量。需要综合运用问卷调查、深度访谈、社会网络分析、地理信息系统、行政数据链接等多种数据收集方法。

• 社会因素测量:设计社会经济地位(SES)测量指标(收入、教育、职业、综合SES指数)、社会资本测量(个人社会资本量表、社区社会资本量表)、社会支持测量(SSRS社会支持评定量表)、邻里环境测量(步行性、社会凝聚、安全性),进行信效度检验
• 多源数据收集:收集个体水平数据(问卷调查、体检数据、健康档案)、社区水平数据(社区调查、人口普查数据、GIS空间数据)、宏观水平数据(区域经济社会指标、卫生统计数据),建立多层次数据库
• 质性数据收集:开展深度访谈和焦点小组讨论,收集参与者对社会因素与健康关系的主观体验和认知,使用Nvivo或ATLAS.ti软件管理质性数据,进行三角验证
产出:社会流行病研究数据集(含定量数据库、质性资料库、测量工具手册、信效度检验报告)| 质量标准:测量工具科学有效,数据来源多样互补,质量控制严格
步骤 3
健康不平等分析与社会决定因素研究
本步骤的核心任务是分析健康不平等状况,研究其社会决定因素。需要量化不同社会经济地位、性别、种族/民族、地域之间的健康差异,分析社会因素如何"嵌入"身体并影响健康。健康不平等分析是社会流行病学的核心内容,也是推动健康公平政策的依据。

• 健康不平等测量:计算健康不平等指数——集中指数(Concentration Index)、斜率指数(Slope Index of Inequality)、相对指数(Relative Index of Inequality)、基尼系数、人群归因分值(PAF),按不同社会维度分解健康差异
• 社会决定因素分析:使用多水平模型(Multilevel Model)分析个体-邻里-区域多层次因素对健康的影响,使用结构方程模型(SEM)分析社会因素的作用路径和中介效应,检验社会梯度(Social Gradient)现象
• 中介与调节分析:分析心理因素(压力、抑郁、社会支持)、行为因素(吸烟、饮酒、饮食、运动)、生物因素(肥胖、高血压、炎症标志物)、医疗因素(可及性、利用)在社会因素与健康之间的中介作用,检验调节效应
产出:健康不平等与社会决定因素分析报告(含不平等指数、多层分析结果、作用路径图、中介效应分析)| 质量标准:不平等测量方法规范,决定因素分析深入,路径分析清晰
步骤 4
生命历程视角与跨学科综合分析
本步骤的核心任务是从生命历程视角研究社会因素对健康的长期影响,进行跨学科综合分析。生命历程视角关注生命早期(甚至孕前)的社会暴露对终生健康和疾病风险的影响,强调时间维度的重要性。跨学科分析能够更全面地理解社会因素影响健康的复杂机制。

• 生命历程分析:运用生命历程理论分析关键期/敏感期(Critical Period)、累积效应(Cumulative Effect)、轨迹效应(Trajectory)、生命事件转换(Transition)对健康的影响,使用生长曲线模型和组基轨迹模型(GBTM)分析发展轨迹
• 跨学科视角整合:整合社会学(社会分层、社会资本)、经济学(收入健康关系、劳动经济学)、心理学(压力过程理论、应对资源)、生物学(应激轴、表观遗传)、流行病学的理论和方法,构建多维度解释框架
• 历史与比较分析:进行历史比较分析(不同时期健康不平等变化)、跨国/跨区域比较分析(不同福利体制、不同社会政策下的健康差异),分析社会政策(教育、医疗、社会保障)对健康公平的影响
产出:生命历程与跨学科综合分析报告(含发展轨迹分析、跨学科解释框架、比较分析结果)| 质量标准:生命历程分析深入,跨学科整合有深度,比较分析有洞见
步骤 5
社会流行病学研究报告与健康公平政策建议
本步骤的核心任务是撰写社会流行病学研究报告,提出促进健康公平的政策建议。社会流行病学不仅要解释健康不平等的原因,更要为减少健康不平等、促进健康公平提供科学依据和政策方案。研究成果应转化为推动社会变革和政策改进的行动。

• 撰写研究报告:按照社会流行病学研究规范撰写完整报告,包括理论框架、研究设计、方法、主要发现、讨论与结论,系统呈现社会因素影响健康的机制和路径,字数不少于4000字
• 健康公平政策建议:基于研究发现提出健康的社会决定因素干预策略,从改善社会经济条件(减贫、教育公平、就业保障)、改善生活和工作环境、加强医疗卫生服务公平性、赋能社区和个人等层面提出政策建议
• 健康影响评估:将研究结果应用于健康影响评估(HIA),评估社会政策(如最低工资、住房政策、教育改革)对健康公平的潜在影响,为政策制定提供健康视角
产出:社会流行病学研究报告、健康公平政策建议书、健康影响评估报告| 质量标准:研究报告学术性强,政策建议有针对性和可行性,健康影响评估科学

Steps

Step 1
Social Epidemiology Problem Selection and Study Design
The core task of this step is to select social epidemiology research questions and design the study. Social epidemiology studies impacts of social factors on population health, focusing on social determinants of health (SDH) and health equity.

• Select research topic: choose from social determinants of health (income, education, occupation, social class, social capital, social support, residential environment, race/ethnicity, gender), health equity, social distribution of health behaviors, community and health, life course perspective
• Theoretical framework construction: select theoretical models (SDH framework, social ecological model, life course theory, social capital theory, social gradient theory, fundamental cause theory); build conceptual framework; propose research hypotheses
• Study design: determine study design type (cross-sectional survey, cohort study, case-control, natural experiment, multilevel analysis, mixed methods); determine study population and sampling methods; select social factor measurement tools and health outcome indicators
Deliverable: Social epidemiology research design proposal (research questions, theoretical framework, study design, measurement tools, sampling plan) | Quality standard: Theoretically and practically significant research question, appropriate theoretical framework, scientific and reasonable design
Step 2
Social Factor Measurement and Data Collection
The core task of this step is to measure social factors and collect relevant data. Measurement of social factors is the difficulty and key of social epidemiology research, requiring operationalization of abstract social concepts into measurable variables.

• Social factor measurement: design SES indicators (income, education, occupation, composite SES index), social capital measures (personal social capital scale, community social capital scale), social support measures (SSRS), neighborhood environment measures (walkability, social cohesion, safety); perform reliability and validity testing
• Multi-source data collection: collect individual-level data (questionnaire survey, physical exam data, health records), community-level data (community surveys, census data, GIS spatial data), macro-level data (regional economic-social indicators, health statistics); build multilevel database
• Qualitative data collection: conduct in-depth interviews and focus group discussions; collect participants' subjective experiences and perceptions of social factors-health relationship; use Nvivo or ATLAS.ti for qualitative data management; perform triangulation
Deliverable: Social epidemiology study dataset (quantitative database, qualitative database, measurement tool manual, reliability/validity report) | Quality standard: Scientific and valid measurement tools, diverse and complementary data sources, strict quality control
Step 3
Health Inequality Analysis and Social Determinants Research
The core task of this step is to analyze health inequality status and study its social determinants. Quantify health disparities across different socioeconomic status, gender, race/ethnicity, and geographic regions.

• Health inequality measurement: calculate health inequality indices—Concentration Index, Slope Index of Inequality, Relative Index of Inequality, Gini coefficient, PAF; decompose health disparities by different social dimensions
• Social determinants analysis: use multilevel models to analyze impacts of individual-neighborhood-regional factors on health; use SEM to analyze pathways and mediating effects of social factors; test social gradient phenomenon
• Mediation and moderation analysis: analyze mediating roles of psychological factors (stress, depression, social support), behavioral factors (smoking, drinking, diet, exercise), biological factors (obesity, hypertension, inflammatory markers), and healthcare factors (access, utilization); test moderating effects
Deliverable: Health inequality and social determinants analysis report (inequality indices, multilevel analysis results, pathway diagrams, mediation analysis) | Quality standard: Standard inequality measurement methods, in-depth determinant analysis, clear pathway analysis
Step 4
Life Course Perspective and Interdisciplinary Comprehensive Analysis
The core task of this step is to study long-term impacts of social factors on health from a life course perspective and conduct interdisciplinary comprehensive analysis. Life course perspective focuses on impacts of early life social exposures on lifelong health.

• Life course analysis: apply life course theory to analyze critical period, cumulative effect, trajectory effect, life transitions impacts on health; use growth curve models and GBTM to analyze developmental trajectories
• Interdisciplinary integration: integrate theories and methods from sociology (social stratification, social capital), economics (income-health relationship, labor economics), psychology (stress process theory, coping resources), biology (stress axis, epigenetics), epidemiology; build multidimensional explanatory framework
• Historical and comparative analysis: perform historical comparative analysis (changes in health inequality over time), cross-national/regional comparative analysis (health disparities under different welfare regimes, different social policies); analyze impacts of social policies (education, healthcare, social security) on health equity
Deliverable: Life course and interdisciplinary comprehensive analysis report (developmental trajectory analysis, interdisciplinary explanatory framework, comparative analysis results) | Quality standard: In-depth life course analysis, deep interdisciplinary integration, insightful comparative analysis
Step 5
Social Epidemiology Research Report and Health Equity Policy Recommendations
The core task of this step is to write a social epidemiology research report and propose policy recommendations for promoting health equity. Social epidemiology should not only explain causes of health inequality but also provide scientific evidence and policy solutions.

• Write research report: compose complete report following social epidemiology research standards, including theoretical framework, study design, methods, main findings, discussion and conclusion; systematically present mechanisms and pathways of social factors affecting health; minimum 4000 words
• Health equity policy recommendations: based on findings, propose SDH intervention strategies; suggest policies from improving socioeconomic conditions (poverty reduction, education equity, employment security), improving living and working environments, strengthening healthcare equity, empowering communities and individuals
• Health impact assessment: apply research findings to health impact assessment (HIA); evaluate potential impacts of social policies (minimum wage, housing policy, education reform) on health equity; provide health perspective for policy-making
Deliverable: Social epidemiology research report, health equity policy recommendation paper, health impact assessment report | Quality standard: Strong academic research report, targeted and feasible policy recommendations, scientific health impact assessment
步骤 2
理论选择
选择适用的健康行为理论框架
产出:理论依据
步骤 3
干预设计
设计具体干预策略和活动内容
产出:干预方案
步骤 4
评估方案
设计干预效果评估指标和方法
产出:评估方案
步骤 5
报告撰写
撰写完整干预方案与评估计划
产出:方案报告

Steps

Step 1
Behavior Analysis
Select health behavior issue and analyze factors
Deliverable: Behavior Analysis
Step 2
Theory Selection
Select applicable health behavior theory
Deliverable: Theoretical Basis
Step 3
Intervention Design
Design intervention strategies and activities
Deliverable: Intervention Plan
Step 4
Evaluation Plan
Design evaluation indicators and methods
Deliverable: Evaluation Plan
Step 5
Report Writing
Write complete intervention and evaluation plan
Deliverable: Proposal Report
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