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APHA Scientific Session and Event Listing

Susan E. Middlestadt, PhD, Applied Health Science, Indiana University, School of Health, Physical Education, and Recreation, Bloomington, IN 47405-4801, 812/856-5768, semiddle@indiana.edu, Julie Pulerwitz, ScD, Horizons/Population Council (seconded from PATH), 4301 Connecticut Avenue, NW Suite 280, Washington, DC 20008, J. Douglas Storey, PhD, Communication Science & Research, The Health Communication Partnership, Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, 111 Market Place, Suite 310, Baltimore, MD 21202, Karabi Acharya, ScD, Center for Global Health and Communication Marketing, Academy for Educational Development (AED), 1875 Connecticut Ave, NW, Washington, DC 20009, and Geeta Nanda, DrPH, Center for Health Policy and Capacity Development, Academy for Educational Development, 1875 Connecticut Ave., NW, Washington, DC 20009.

Background: Applied communication and behavioral scientists have had success in developing programs that improve health by addressing specific, usually single, behaviors. Increasingly, however, in the interest of efficiency and long-term effectiveness in a time of limited resources, it makes sense to look for approaches that can have a broad impact and improve health through multiple behaviors. Improving gender norms, expectations that men and women hold about what they should do as men and women, has been suggested as such an approach that might improve several sexual and reproductive health behaviors.

Purpose: The purpose of this presentation is to explore the conceptual and operational definitions of norms as factors influencing health behavior

Method: Literature review, theoretical analysis, and discussion among a working group of the communication, gender, and behavior change specialists were used to develop a framework for discussing uses and meanings of the term norms and social norms.

Results: The conceptual framework differentiates: among perceived and actual norms; descriptive and injunctive norms; proscriptive and prescriptive norms; and normative beliefs with respect to an individual's performance of a specific behavior and gender norms as general expectations for what men and women as supposed to do. It outlines how these might be inter-related and lead to improved health behavior and health status outcomes.

Discussion: Implications for interventions to improve gender norms in order to have a broad scale impact on sexual and reproductive health will be discussed. Particular attention will be paid to international applications and to changing expectations for males.

Learning Objectives:

Participant will be able (
• to define and differentiate gender norms and other related normative constructs; (
• to outline how improving gender norms might improve several sexual and reproductive health behaviors.

Presenting author's disclosure statement:

Not Answered