Abstract for: Social norms underlying health behaviors: Developing a feedback theory of social norm adoption for public health

Social norms play an important role in understanding health behavior in public health, health disparities, and social determinants of health. Despite the potential for social norms to be leveraged for health promotion and interventions, the evolution of norms make them difficult to target and transform. Specifically, the dynamics of social norm emergence and adoption remain largely understudied from a feedback perspective. This research draws on complexity theory and system dynamics to develop a feedback theory of social norm adoption based on published literature. Literature is qualitatively analyzed using a grounded theory approach to construct a qualitative system dynamics model of the social norms underlying health behavior. Using grounded theory, the research develops a system dynamics causal loop diagram and identifies three major sets or subsystems of social mechanisms: interpersonal, intrapersonal, and institutional. Across all social mechanisms, power is found to be essential in distinguishing who creates versus follows social norms. The resulting feedback theory of social norm adoption can serve as a launching point for public health researchers to conduct systems-level, equity-focused research. This feedback theory can be applied to public health research to illuminate sociocultural factors that mediate health behavior